Reasons for accepting or declining Down syndrome screening in Dutch prospective mothers within the context of national policy and healthcare system characteristics: a qualitative study.

Science.gov (United States)

Crombag, Neeltje M T H; Boeije, Hennie; Iedema-Kuiper, Rita; Schielen, Peter C J I; Visser, Gerard H A; Bensing, Jozien M

2016-05-26

Uptake rates for Down syndrome screening in the Netherlands are low compared to other European countries. To investigate the low uptake, we explored women's reasons for participation and possible influences of national healthcare system characteristics. Dutch prenatal care is characterised by an approach aimed at a low degree of medicalisation, with pregnant women initially considered to be at low risk. Prenatal screening for Down syndrome is offered to all women, with a 'right not to know' for women who do not want to be informed on this screening. At the time this study was performed, the test was not reimbursed for women aged 35 and younger. We conducted a qualitative study to explore reasons for participation and possible influences of healthcare system characteristics. Data were collected via ten semi-structured focus groups with women declining or accepting the offer of Down syndrome screening (n = 46). All focus groups were audio- and videotaped, transcribed verbatim, coded and content analysed. Women declining Down syndrome screening did not consider Down syndrome a condition severe enough to justify termination of pregnancy. Young women declining felt supported in their decision by perceived confirmation of their obstetric caregiver and reassured by system characteristics (costs and age restriction). Women accepting Down syndrome screening mainly wanted to be reassured or be prepared to care for a child with Down syndrome. By weighing up the pros and cons of testing, obstetric caregivers supported young women who accepted in the decision-making process. This was helpful, although some felt the need to defend their decision to accept the test offer due to their young age. For some young women accepting testing, costs were considered a disincentive to participate. Presentation of prenatal screening affects how the offer is attended to, perceived and utilised. By offering screening with age restriction and additional costs, declining is considered the

Contemporary Obstetric Triage.

Science.gov (United States)

Sandy, Edward Allen; Kaminski, Robert; Simhan, Hygriv; Beigi, Richard

2016-03-01

The role of obstetric triage in the care of pregnant women has expanded significantly. Factors driving this change include the Emergency Medical Treatment and Active Labor Act, improved methods of testing for fetal well-being, increasing litigation risk, and changes in resident duty hour guidelines. The contemporary obstetric triage facility must have processes in place to provide a medical screening examination that complies with regulatory statues while considering both the facility's maternal level of care and available resources. This review examines the history of the development of obstetric triage, current considerations in a contemporary obstetric triage paradigm, and future areas for consideration. An example of a contemporary obstetric triage program at an academic medical center is presented. A successful contemporary obstetric triage paradigm is one that addresses the questions of "sick or not sick" and "labor or no labor," for every obstetric patient that presents for care. Failure to do so risks poor patient outcome, poor patient satisfaction, adverse litigation outcome, regulatory scrutiny, and exclusion from federal payment programs. Understanding the role of contemporary obstetric triage in the current health care environment is important for both providers and health care leadership. This study is for obstetricians and gynecologists as well as family physicians. After completing this activity, the learner should be better able to understand the scope of a medical screening examination within the context of contemporary obstetric triage; understand how a facility's level of maternal care influences clinical decision making in a contemporary obstetric triage setting; and understand the considerations necessary for the systematic evaluation of the 2 basic contemporary obstetric questions, "sick or not sick?" and "labor or no labor?"

Security in the Dutch electronic patient record system

NARCIS (Netherlands)

van 't Noordende, G.

2010-01-01

In this article, we analyze the security architecture of the Dutch Electronic Patient Dossier (EPD) system. Intended as a mandatory infrastructure for exchanging medical records of most if not all patients in the Netherlands among authorized parties (particularly, physicians), the EPD has to address

Current applications of big data in obstetric anesthesiology.

Science.gov (United States)

Klumpner, Thomas T; Bauer, Melissa E; Kheterpal, Sachin

2017-06-01

The narrative review aims to highlight several recently published 'big data' studies pertinent to the field of obstetric anesthesiology. Big data has been used to study rare outcomes, to identify trends within the healthcare system, to identify variations in practice patterns, and to highlight potential inequalities in obstetric anesthesia care. Big data studies have helped define the risk of rare complications of obstetric anesthesia, such as the risk of neuraxial hematoma in thrombocytopenic parturients. Also, large national databases have been used to better understand trends in anesthesia-related adverse events during cesarean delivery as well as outline potential racial/ethnic disparities in obstetric anesthesia care. Finally, real-time analysis of patient data across a number of disparate health information systems through the use of sophisticated clinical decision support and surveillance systems is one promising application of big data technology on the labor and delivery unit. 'Big data' research has important implications for obstetric anesthesia care and warrants continued study. Real-time electronic surveillance is a potentially useful application of big data technology on the labor and delivery unit.

Role of telephone triage in obstetrics.

Science.gov (United States)

Manning, Nirvana Afsordeh; Magann, Everett F; Rhoads, Sarah J; Ivey, Tesa L; Williams, Donna J

2012-12-01

The telephone has become an indispensable method of communication in the practice of obstetrics. The telephone is one of the primary methods by which the patient makes her appointments and contacts her health care provider for advice, reassurance, and referrals. Current methods of telephone triage include personal at the physicians' office, telephone answering services, labor and delivery nurses, and a dedicated telephone triage system using algorithms. Limitations of telephone triage include the inability of the provider to see the patient and receive visual clues from the interaction and the challenges of obtaining a complete history over the telephone. In addition, there are potential safety and legal issues with telephone triage. To date, there is insufficient evidence to either validate or refute the use of a dedicated telephone triage system compared with a traditional system using an answering service or nurses on labor and delivery. Obstetricians and gynecologists, family physicians. After completing this CME activity, physicians should be better able to analyze the scope of variation in telephone triage across health care providers and categorize the components that go into a successful triage system, assess the current scope of research in telephone triage in obstetrics, evaluate potential safety and legal issues with telephone triage in obstetrics, and identify issues that should be addressed in any institution that is using or implementing a system of telephone triage in obstetrics.

Rural-urban inequity in unmet obstetric needs and functionality of emergency obstetric care services in a Zambian district

DEFF Research Database (Denmark)

Phiri, Selia Ng'Anjo; Fylkesnes, Knut; Moland, Karen Marie

2016-01-01

. Method: A cross-sectional survey was conducted in 2011 as part of the 'Response to Accountable priority setting for Trust in health systems' (REACT) project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included...... registers from maternity ward admission, delivery and operation theatre, and case records. Data included age, parity, mode of delivery, obstetric complications, and outcome of mother and the newborn. An approach using estimated major obstetric interventions expected but not done in health facilities...

The Dutch system of education and training in radiation protection. Past, present and future

International Nuclear Information System (INIS)

Boersma, Hielke Freerk

2013-01-01

The earliest courses in 'Radiation Protection (RP) Education and Training in the Netherlands' date back to the late fifties, a time which saw major developments especially in both nuclear medicine and nuclear power. The Dutch Society for Radiation Protection (NVS - Nederlandse Vereinigung voor Strahlingshygiene), established in 1960, is in fact the result of one of the first RP courses for medical doctors. The current system of recognition of RP courses was implemented in 1984 in Dutch legislation, based on an advice of the Dutch Health Council from 1972 (.). The recognition system has fundamentally remained unchanged since then. Radiation protection courses in the Netherlands based on this system already started in the seventies. After many discussions in the past decade the system will change in the next years in close relation to the start of a system of registration of RPes. In this paper I will start with a short introduction of the Dutch system of RP education and training. I will consecutively describe the background of the future changes in our system. Finally the major changes will be given. In the end I hope to have convinced you of the fact that although we face some major changes in the near future, the basis of the current system of education and training in RP will remain. (orig.)

The Dutch system of education and training in radiation protection. Past, present and future

Energy Technology Data Exchange (ETDEWEB)

Boersma, Hielke Freerk [Groningen Univ. (Netherlands). Office of the Univ. Health, Safety and Environment

2013-09-01

The earliest courses in 'Radiation Protection (RP) Education and Training in the Netherlands' date back to the late fifties, a time which saw major developments especially in both nuclear medicine and nuclear power. The Dutch Society for Radiation Protection (NVS - Nederlandse Vereinigung voor Strahlingshygiene), established in 1960, is in fact the result of one of the first RP courses for medical doctors. The current system of recognition of RP courses was implemented in 1984 in Dutch legislation, based on an advice of the Dutch Health Council from 1972 (.). The recognition system has fundamentally remained unchanged since then. Radiation protection courses in the Netherlands based on this system already started in the seventies. After many discussions in the past decade the system will change in the next years in close relation to the start of a system of registration of RPes. In this paper I will start with a short introduction of the Dutch system of RP education and training. I will consecutively describe the background of the future changes in our system. Finally the major changes will be given. In the end I hope to have convinced you of the fact that although we face some major changes in the near future, the basis of the current system of education and training in RP will remain. (orig.)

The actual role of general practice in the Dutch health-care system: results of the Second Dutch National Survey of General Practice.

OpenAIRE

Schellevis, F.G.; Westert, G.P.; Bakker, D.H. de

2005-01-01

A second Dutch National Survey of General Practice was carried out in 2001 with the aim of providing actual information about the role of general practice in the Dutch health-care system for researchers and policy makers. Data were collected on different levels (patients, general practitioners, practices) and included morbidity (self-report and presented to general practitioners), diagnostic and therapeutic interventions, doctor-patient communication, and background characteristics. Compared ...

Recommendations for obstetric management and principles of cooperation between rheumatologists and obstetricians in systemic connective tissue disease patients

Directory of Open Access Journals (Sweden)

Justyna Teliga-Czajkowska

2014-03-01

Full Text Available Systemic connective tissue diseases, notably rheumatoid arthritis and systemic lupus erythematosus, frequently affect women of reproductive age. The significant impact of the diseases on the course of pregnancy is well established, and vice versa – the course of systemic connective tissue diseases may be affected by pregnancy. The risk of developing serious pregnancy complications and obstetric failures is markedly higher in the mentioned disease group. The foundation of obstetric success, i.e. giving birth to a healthy child and pregnancy having no effect on the course of a given autoimmune disease, is cooperation between rheumatologists and obstetricians so as to plan procreation at an optimal period and provide accurate pregnancy monitoring. The article delineates recommendations relating to contraception management, obstetric supervision and fetus wellbeing monitoring, from the point of view of the obstetrician.

Obstetric violence according to obstetric nurses

OpenAIRE

Michelle Gonçalves da Silva; Michelle Carreira Marcelino; Lívia Shélida Pinheiro Rodrigues; Rosário Carcaman Toro; Antonieta Keiko Kakuda Shimo

2014-01-01

The objective was to report the experience of obstetric nurses on the obstetric violence experienced, witnessed and observed during their professional careers. This study is based on an account of experience of working in several health institutions such as basic health units, private and public hospitals, located in São Paulo, Brazil, in a period 5-36 years of technical training and professional experience from 1977 to 2013. The technique to expose the professional experiences was brainstorm...

What can we learn from the Dutch cannabis coffeeshop system?

Science.gov (United States)

MacCoun, Robert J

2011-11-01

To examine the empirical consequences of officially tolerated retail sales of cannabis in the Netherlands, and possible implications for the legalization debate. Available Dutch data on the prevalence and patterns of use, treatment, sanctioning, prices and purity for cannabis dating back to the 1970s are compared to similar indicators in Europe and the United States. The available evidence suggests that the prevalence of cannabis use among Dutch citizens rose and fell as the number of coffeeshops increased and later declined, but only modestly. The coffeeshops do not appear to encourage escalation into heavier use or lengthier using careers, although treatment rates for cannabis are higher than elsewhere in Europe. Scatterplot analyses suggest that Dutch patterns of use are very typical for Europe, and that the 'separation of markets' may indeed have somewhat weakened the link between cannabis use and the use of cocaine or amphetamines. Cannabis consumption in the Netherlands is lower than would be expected in an unrestricted market, perhaps because cannabis prices have remained high due to production-level prohibitions. The Dutch system serves as a nuanced alternative to both full prohibition and full legalization. © 2011 The Author, Addiction © 2011 Society for the Study of Addiction.

Using the unmet obstetric needs indicator to map inequities in life-saving obstetric interventions at the local health care system in Kenya

DEFF Research Database (Denmark)

Echoka, Elizabeth; Dubourg, Dominique; Makokha, Anselimo

2014-01-01

BackgroundDeveloping countries with high maternal mortality need to invest in indicators that not only provide information about how many women are dying, but also where, and what can be done to prevent these deaths. The unmet Obstetric Needs (UONs) concept provides this information. This concept...... was applied at district level in Kenya to assess how many women had UONs and where the women with unmet needs were located.MethodsA facility based retrospective study was conducted in 2010 in Malindi District, Kenya. Data on pregnant women who underwent a major obstetric intervention (MOI) or died...... in facilities that provide comprehensive Emergency Obstetric Care (EmOC) services in 2008 and 2009 were collected. The difference between the number of women who experienced life threatening obstetric complications and those who received care was quantified. The main outcome measures in the study were...

Op weg naar een accreditatiesysteem van Nederlandse ziekenhuizen [Towards an accreditation system of Dutch hospitals

NARCIS (Netherlands)

Gennip, E.M.S.J. van; Linnebank, F.; Sillevis Smitt, P.A.E.; Geldof, C.A.

1999-01-01

The development of the Netherlands system for accreditation of hospitals started in 1989 in the Pilotproject Accreditation (PACE). This resulted in the establishment of the Netherlands Institute for Accreditation of Hospitals (NIAH) early 1999, by the Dutch Association of Hospitals, the Dutch

Third Dutch Process Security Control Event

NARCIS (Netherlands)

Luiijf, H.A.M.

2009-01-01

On June 4th, 2009, the third Dutch Process Control Security Event took place in Amsterdam. The event, organised by the Dutch National Infrastructure against Cybercrime (NICC), attracted both Dutch process control experts and members of the European SCADA and Control Systems Information Exchange

A security analysis of the Dutch electronic patient record system

NARCIS (Netherlands)

van 't Noordende, G.

2010-01-01

In this article, we analyze the security architecture of the Dutch Electronic Patient Dossier (EPD) system. Intended as a national infrastructure for exchanging medical patient records among authorized parties (particularly, physicians), the EPD has to address a number of requirements, ranging from

Non-physician providers of obstetric care in Mexico: Perspectives of physicians, obstetric nurses and professional midwives

Directory of Open Access Journals (Sweden)

DeMaria Lisa M

2012-04-01

Full Text Available Abstract Background In Mexico 87% of births are attended by physicians. However, the decline in the national maternal mortality rate has been slower than expected. The Mexican Ministry of Health’s 2009 strategy to reduce maternal mortality gives a role to two non-physician models that meet criteria for skilled attendants: obstetric nurses and professional midwives. This study compares and contrasts these two provider types with the medical model, analyzing perspectives on their respective training, scope of practice, and also their perception and/or experiences with integration into the public system as skilled birth attendants. Methodology This paper synthesizes qualitative research that was obtained as a component of the quantitative and qualitative study that evaluated three models of obstetric care: professional midwives (PM, obstetric nurses (ON and general physicians (GP. A total of 27 individual interviews using a semi-structured guide were carried out with PMs, ONs, GPs and specialists. Interviews were transcribed following the principles of grounded theory, codes and categories were created as they emerged from the data. We analyzed data in ATLAS.ti. Results All provider types interviewed expressed confidence in their professional training and acknowledge that both professional midwives and obstetric nurses have the necessary skills and knowledge to care for women during normal pregnancy and childbirth. The three types of providers recognize limits to their practice, namely in the area of managing complications. We found differences in how each type of practitioner perceived the concept and process of birth and their role in this process. The barriers to incorporation as a model to attend birth faced by PMs and ONs are at the individual, hospital and system level. GPs question their ability and training to handle deliveries, in particular those that become complicated, and the professional midwifery model particularly as it relates to

The Dutch gas policy: 'Dutch disease' or imaginary disease. CERI Studies Nr 11

International Nuclear Information System (INIS)

Crowley, John

1998-04-01

The Netherlands are the first European gas producer and exporter. The author proposes an analysis of the gas policy of this country. He first recalls some elements of context: peculiarities of energy as a domain of public policy, and characteristics of the Dutch political system. He recalls the historical development of the Dutch gas industry from the 1960's: political economics of natural gas and of competing fuels, development of the Groningen site as the keystone of the Dutch gas policy, and regulation of the industrial sector. In the next part, the author comments the emergence of energy as a topic of public debate from 1995, and how the Dutch gas policy has been put into question again: actors and interaction dynamics, stakes, present policy and perspectives

The Pattern and Obstetric Outcome of Hypertensive Disorders of ...

African Journals Online (AJOL)

There is need for strengthening of communication and referral systems in the healthcare. KEY WORDS: Hypertensive disorders, pattern, obstetrics outcome. Erratum Note: Mbachu 1, Udigwe GO, Okafor CI, Umeonunihu OS, Ezeama C, Eleje GU on the article “The Pattern and Obstetric Outcome of Hypertensive Disorders of ...

Exploring the effectiveness of obstetrics and gynecology information systems in hospitals of a developing country: A qualitative content analysis

Directory of Open Access Journals (Sweden)

Hassan Babamohamadi

2016-07-01

Full Text Available Obstetrics and gynecology information systems are designed to replace paper charts, interact with other clinical wards of hospital, and to better care for patients. This qualitative study was performed to explore the perception of midwives about the effectiveness of information systems. In this qualitative study, data were collected through semistructured and in-depth interviews and analyzed by content analysis and constant comparison method. Participants were 15 midwives from obstetrics and gynecology units of affiliated hospitals of Semnan University of Medical Sciences, Iran. Purposeful sampling method was used and continued until data saturation. The several themes that emerged from the interviews were divided into strength and weak points. Strength points included the facilitating the recording of information, reduction of costs and time, and the weakness points were repetition of tasks, low computer literacy of the staff, system restrictions on recording and editing, the unavailability of system and reduced the role of midwives in patient care. Midwives were faced with challenges in the use of information systems indicating the lack of quality of the information system. It seems that reinforcing strength points and resolving hardware and software problems can increase obstetrics and gynecology staff’s acceptance of this information system and reduce their cultural resistance toward it.

Evaluating perinatal outcomes in different levels of care

NARCIS (Netherlands)

Wiegerinck, M.M.J.

2018-01-01

The safety of the Dutch obstetric system has been subject of debate for many years. The typical obstetric system in the Netherlands is characterized by a formal distinction between independent midwife-led primary care and obstetrician-led secondary care. Pregnant women who are considered low risk

Comparison between Dutch and German buildings

Energy Technology Data Exchange (ETDEWEB)

Lony, R.J.M.; Molenaar, D.J.; Rietkerk, J.; Schuiling, D.J.B.W.; Zeiler, W. [TU/e, Univ. of Technology Eindhoven (Netherlands); Brunk, M. [RWTH Aachen (Germany)

2006-07-01

German buildings are often seen as an example to Dutch architects and Dutch building services consultants. Goal of this article is to examine and to understand differences between the Dutch and German top office buildings. Objective is to examine to which extent these buildings were designed intelligently. An Intelligent Building is one that provides a productive cost effective environment through the optimisation of six basic elements; site, skin, systems, structures, services, space plan and staff and the interrelationship between them. Based on these six aspects the comparison is made between Dutch and German buildings. (orig.)

A change of direction in the Dutch health care system?

Science.gov (United States)

Lapré, R M

1988-08-01

The Dutch health care system seems to be undergoing a clear change of direction. The publication of the Report of the Committee of the Structure and Financing of the Health Care System is a prominent document which marks the emergence of a new trend. After an analysis of the characteristics of the Dutch health care system in the periods 1960-1975 and 1975-1985, an account is given of the most important proposals of the committee. The proposals clearly alter the trend towards more governmental involvement. They envisage a more market-oriented approach and freedom of operation while at the same time paying attention to aspects such as solidarity and social justice. The Committee's suggestions include the introduction of a basic insurance scheme for every citizen with a coverage determined by law, and in addition a voluntary supplementary insurance scheme in which the insured can decide what coverage he requires and that the insurer is obliged to accept him. The fact that there is a certain amount of agreement, at least over the direction that the strategy for change should take, justifies the expectation that many of the committee's proposals will be implemented.

A longitudinal approach to changes in the motivation of dutch pharmacists in the current continuing education system

NARCIS (Netherlands)

Sharon, L.; de Boer, Anthonius; Croiset, Gerda; Kusurkar, Rashmi A; Koster, Andries S.

Objective. To explore the changes in motivation of Dutch pharmacists for Continuing Education (CE) in the Dutch CE system. Methods. Pharmacists’ motivation was measured across three time points with the Academic Motivation Scale, based on the Self-Determination Theory of motivation. The Latent

A Longitudinal Approach to Changes in the Motivation of Dutch Pharmacists in the Current Continuing Education System.

Science.gov (United States)

Tjin A Tsoi, Sharon L; de Boer, Anthonius; Croiset, Gerda; Kusurkar, Rashmi A; Koster, Andries S

2018-03-01

Objective. To explore the changes in motivation of Dutch pharmacists for Continuing Education (CE) in the Dutch CE system. Methods. Pharmacists' motivation was measured across three time points with the Academic Motivation Scale, based on the Self-Determination Theory of motivation. The Latent Growth Modelling technique was used to analyze these data. Results. Over a period of 21 months, Controlled Motivation had increased and Relative Autonomous Motivation of Dutch pharmacists had decreased. Traineeship was the only demographic factor with a significant influence on the change in motivation. No subgroups with different trajectories could be identified. Conclusion. Relative Autonomous Motivation of Dutch pharmacists for CE decreases over time. This indicates a loss of Autonomous Motivation ("good" motivation) in favor of Controlled Motivation ("bad" motivation). Further research needs to be conducted to gain a better understanding of the association between pharmacist motivation and the features of the current CE system.

Morbidity and mortality associated with obstetric hysterectomy

International Nuclear Information System (INIS)

Shaikh, N.B.; Shaikh, S.; Shaikh, J.M.

2010-01-01

Background: Obstetric hysterectomy still complicates a substantial number of pregnancies in third world countries and is a significant cause of obstetric morbidity and mortality. This study was carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, risk factors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study of all patients who under went obstetric hysterectomy was conducted from May 1, 2004 to October 31, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical and Health Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the data was fed to SPSS in the form of frequency distribution tables and percentages were calculated. Statistical analysis of data was performed by using Chi-square test. The level of significance was taken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41 cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158 deliveries. Most of patients were from rural areas (82.92%), un-booked 73.17%), uneducated (95%), lower socio economical class (92.69%), 25-29 years age (48.78%) multiparae (56.10%), have to travel a distance of <100 km to reach hospital and referred late (51%) by health care providers (doctors). Majority of hysterectomies were performed due to ruptured uteri (51.21%). There were 5 maternal and 26 perinatal deaths; all were due to severity of conditions necessitating hysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. The reason being many avoidable factors such as high parity, inadequate maternity and family planning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracy on the part of woman herself, family and health care providers are not taken care of during pregnancy, labour and puerperium. (author)

Obstetric airway management

African Journals Online (AJOL)

of stomach contents into the lungs during obstetric anesthesia.8 ... Both of the mortalities occurred secondary to solid ... The large number of deaths ... subcategories of patients as a first-line airway device, and are increasingly being ... outline the problems with obstetric airway management, and then focus on a few of the ...

Addressing the third delay: implementing a novel obstetric triage system in Ghana.

Science.gov (United States)

Goodman, David M; Srofenyoh, Emmanuel K; Ramaswamy, Rohit; Bryce, Fiona; Floyd, Liz; Olufolabi, Adeyemi; Tetteh, Cecilia; Owen, Medge D

2018-01-01

Institutional delivery has been proposed as a method for reducing maternal morbidity and mortality, but little is known about how referral hospitals in low-resource settings can best manage the expected influx of patients. In this study, we assess the impact of an obstetric triage improvement programme on reducing hospital-based delay in a referral hospital in Accra, Ghana. An Active Implementation Framework is used to describe a 5-year intervention to introduce and monitor obstetric triage capabilities. Baseline data, collected from September to November 2012, revealed significant delays in patient assessment on arrival. A triage training course and monitoring of quality improvement tools occurred in 2013 and 2014. Implementation barriers led to the construction of a free-standing obstetric triage pavilion, opened January 2015, with dedicated midwives. Data were collected at three time intervals following the triage pavilion opening and compared with baseline including: referral indications, patient and labour characteristics, waiting time from arrival to assessment and the documentation of a care plan. An obstetric triage improvement programme reduced the median (IQR) patient waiting time from facility arrival to first assessment by a midwife from 40 min (15-100) to 5 min (2-6) (p<0.001) over the 5-year intervention. The triage pavilion enhanced performance resulting in the elimination of previous delays associated with the time of admission and disease acuity. Care plan documentation increased from 51% to 96%. Obstetric triage, when properly implemented, reduced delay in a busy, low-resource hospital. The implementation process was sustained under local leadership during transition to a new hospital.

Developing a national performance indicator framework for the Dutch health system

NARCIS (Netherlands)

ten Asbroek, A. H. A.; Arah, O. A.; Geelhoed, J.; Custers, T.; Delnoij, D. M.; Klazinga, N. S.

2004-01-01

Objective. To report on the first phase of the development of a national performance indicator framework for the Dutch health system. Methods. In January 2002, we initiated an informed interactive process with the intended users-policymakers at the Ministry of Health, Welfare and Sport-and academics

Developing a national performance indicator framework for the Dutch health system.

NARCIS (Netherlands)

Asbroek, A.H.A. ten; Arah, O.A.; Geelhoed, J.; Custers, J.; Delnoij, D.M.; Klazinga, N.S.

2004-01-01

Objective. To report on the first phase of the development of a national performance indicator framework for the Dutch health system. Methods. In January 2002, we initiated an informed interactive process with the intended users-policymakers at the Ministry of Health, Welfare and Sport—and academics

The whereabouts of Migrants : A comparison of Dutch migrant registration systems

NARCIS (Netherlands)

van Faassen, M.

2017-01-01

The whereabouts of migrants: a comparison of Dutch migrant registration systems. Today, one way of visualising the current refugee and migrant crisis on the outer borders of Europe is by showing a bottleneck in the processing of migrant flows: large groups of people waiting endlessly for their

Perceived Health System Causes of Obstetric Fistula from Accounts ...

African Journals Online (AJOL)

AJRH Managing Editor

of Affected Women in Rural Tanzania: A Qualitative Study. 1*. Lilian T. .... achieved after 16 interviews, where answers from women .... delivery is crucial for safety of the future mothers and their ..... among obstetric care givers in public health.

Opinions regarding neonatal resuscitation training for the obstetric physician: a survey of neonatal and obstetric training program directors.

Science.gov (United States)

Bruno, C J; Johnston, L; Lee, C; Bernstein, P S; Goffman, D

2018-04-01

Our goal was to garner opinions regarding neonatal resuscitation training for obstetric physicians. We sought to evaluate obstacles to neonatal resuscitation training for obstetric physicians and possible solutions for implementation challenges. We distributed a national survey via email to all neonatal-perinatal medicine fellowship directors and obstetrics & gynecology residency program directors in the United States. This survey was designed by a consensus method. Ninety-eight (53%) obstetric and fifty-seven (51%) neonatal program directors responded to our surveys. Eighty-eight percent of neonatologists surveyed believe that obstetricians should be neonatal resuscitation program (NRP) certified. The majority of surveyed obstetricians (>89%) believe that obstetricians should have some neonatal resuscitation training. Eighty-six percent of obstetric residents have completed training in NRP, but only 19% of obstetric attendings are NRP certified. Major barriers to NRP training that were identified include time, lack of national requirement, lack of belief it is helpful, and cost. Most obstetric attendings are not NRP certified, but the majority of respondents believe that obstetric providers should have some neonatal resuscitation training. Our study demonstrates that most respondents support a modified neonatal resuscitation course for obstetric physicians.

Tradeable emission permits in Dutch environmental policy. A utopia?

International Nuclear Information System (INIS)

Schuurman, S.J.

1997-01-01

Because of the lack of experience with permits in the Netherlands, and in view of the similarities between various other tradeable permit systems, the functioning of Dutch systems of tradeable fish, milk and manure quotas is discussed. Evaluation of these systems is based on criteria of effectiveness, target-group efficiency and government efficiency. These systems of tradeable permits appear to constitute a successful addition to the Dutch policy of direct regulation. Considering this, and the favorable American experience with the Emissions Trading Program, tradeable emission permits deserve a chance to be implemented in Dutch environmental policy. The question remains, however, whether the Dutch government is ready for such a step. 28 refs

Enhancing teaching and learning in the Dutch vocational education system : Reforms enacted

NARCIS (Netherlands)

Elly de Bruijn; Stephen Billett; Jeroen Onstenk

2017-01-01

This book discusses how the Dutch vocational education system has undergone significant waves of reform driven by global imperatives, national concerns and governmental policy goals. Like elsewhere, the impetuses for these reforms are directed to generating a more industry-responsive,

Invisible wounds: obstetric violence in the United States.

Science.gov (United States)

Diaz-Tello, Farah

2016-05-01

In recent years, there has been growing public attention to a problem many US health institutions and providers disclaim: bullying and coercion of pregnant women during birth by health care personnel, known as obstetric violence. Through a series of real case studies, this article provides a legal practitioner's perspective on a systemic problem of institutionalized gender-based violence with only individual tort litigation as an avenue for redress, and even that largely out of reach for women. It provides an overview of the limitations of the civil justice system in addressing obstetric violence, and compares alternatives from Latin American jurisdictions. Finally, the article posits policy solutions for the legal system and health care systems. Copyright © 2016 Elsevier Inc. All rights reserved.

Domestic violence in the pregnant patient: obstetric and behavioral interventions.

Science.gov (United States)

Mayer, L; Liebschutz, J

1998-10-01

Every day, obstetric providers treat patients experiencing domestic violence. Domestic violence can have both dramatic and subtle impacts on maternal and fetal morbidity and mortality. This article enumerates patient risk factors for and obstetric consequences of domestic violence. It describes adaptations to the assessment and treatment of pregnancy complications occurring in the context of domestic violence and presents behavioral interventions that can be performed within existing obstetric care delivery systems. Behavioral interventions include assessments of a patient's readiness for change and her emotional responses to the violence. Obstetric interventions include an assessment of risk of physical harm to a pregnant woman and her fetus from domestic violence. Interviewing techniques include educating the patient about the effects of abuse and, over time, validating a patient's efforts to change. Reliance on a team approach and use of community resources are emphasized. All of these mechanisms enable obstetric providers to assist pregnant women in taking steps to end the abuse.

[Obstetric hysterectomy. Incidence, indications and complications].

Science.gov (United States)

Vázquez, Juan A Reveles; Rivera, Geannyne Villegas; Higareda, Salvador Hernández; Páez, Fernando Grover; Vega, Carmen C Hernández; Segura, Agustin Patiño

2008-03-01

Obstetric hysterectomy is indicated when patient's life is at risk, and it is a procedure that requires a highly experienced and skilled medical team to solve any complication. To identify incidence, indications, and complications of obstetric hysterectomy within a high-risk population. Transversal, retrospective study from July 1st 2004 to June 30 2006 at Unidad Medica de Alta Especialidad, Hospital de Ginecoobstetricia, Centro Medico Nacional de Occidente, IMSS. There were reviewed 103 patient' files with obstetric hysterectomy. Incidence was calculated, and clinical and socio-demographic characteristics, indications, and complications of obstetric hysterectomy identified and expressed in frequency, percentages, and central tendency measurements. Incidence of obstetric hysterectomy was 8 cases within every 1,000 obstetric consultation. Age average was 31.1 +/- 5.1 years. 72.8% had cesarean surgery history. Main indication was placenta previa associated with placenta accreta (33%), followed by uterine hypotony (22.3%). Complications were hypovolemic shock (56.3%), and vesical injuries (5.8%). There were no maternal deaths. Cesarean history induces higher obstetric hysterectomy incidence in women with high-risk pregnancy, due to its relation to placentation disorders, as placenta previa that increases hemorrhage possibility, and thus, maternal morbidity and mortality.

Obstetrical and perinatal outcomes in patients with or without obstetric analgesia during labor

Directory of Open Access Journals (Sweden)

Piedrahíta-Gutiérrez, Dany Leandro

2016-07-01

Full Text Available Objective: To describe and compare the obstetric and perinatal outcomes in patients with or without obstetric analgesia during labor, and to determine whether such analgesia is associated with adverse maternal or perinatal outcomes. Methodology: Comparative, retrospective, descriptive study, between January and November 2014, that included 502 healthy patients with normal pregnancies, out of which 250 received obstetric analgesia. The groups were compared as to maternal and perinatal outcomes. Results: Young, single and nulliparous mothers predominated; delivery was vaginal in 86 % of the cases, and by caesarean section in 14 %. Obstetric analgesia was associated with longer duration of the second stage of labor, instrumental delivery and cesarean section due to arrest of dilatation or fetal bradycardia; however, it was not related with higher incidence of postpartum hemorrhage or adverse perinatal outcomes such as meconium-stained amniotic fluid, Apgar under 5 at one minute or under 7 at 5 minutes, the need for neonatal resuscitation or for admission to NICU. Conclusion: Obstetric analgesia increases the duration of the second stage of labor and can increase the rate of caesarean sections and instrumental delivery, but it is not associated with adverse maternal or perinatal outcomes. Therefore, its use in labor is justified.

A critical approach to some new ideas about the Dutch flood risk system

NARCIS (Netherlands)

Rijcken, T.

2015-01-01

Decisions on measures to improve a flood risk system are in part supported by general ideas about how the system works and should work. After the completion of the Dutch Delta Works around 1990, such new ideas regarding flood risk emerged. Some of these may be appealing at first, but appear

ASSESSMENT OF THE VOLUNTEERED GEOGRAPHIC INFORMATION FEEDBACK SYSTEM FOR THE DUTCH TOPOGRAPHICAL KEY REGISTER

Directory of Open Access Journals (Sweden)

M. Grus

2015-08-01

Full Text Available Since Topographical Key Register has become an open data the amount of users increased enormously. The highest grow was in the private users group. The increasing number of users and their growing demand for high actuality of the topographic data sets motivates the Dutch Kadaster to innovate and improve the Topographical Key Register (BRT. One of the initiatives was to provide a voluntary geographical information project aiming at providing a user-friendly feedback system adjusted to all kinds of user groups. The feedback system is a compulsory element of the Topographical Key Register in the Netherlands. The Dutch Kadaster is obliged to deliver a feedback system and the key-users are obliged to use it. The aim of the feedback system is to improve the quality and stimulate the usage of the data. The results of the pilot shows that the user-friendly and open to everyone feedback system contributes enormously to improve the quality of the topographic dataset.

DutchParl: A corpus of parliamentary documents in Dutch

NARCIS (Netherlands)

Marx, M.; Schuth, A.

2010-01-01

A corpus called DutchParl is created which aims to contain all digitally available parliamentary documents written in the Dutch language. The first version of DutchParl contains documents from the parliaments of The Netherlands, Flanders and Belgium. The corpus is divided along three dimensions: per

Functional food monitoring as part of the new Dutch dietary monitoring system

NARCIS (Netherlands)

Rompelberg CJM; Jager M; Bakker MI; Buurma-Rethans EJM; Ocke MC; CVG

2006-01-01

Good data on functional food consumption necessary for an adequate Dutch nutrition policy are lacking. This lack may be overcome in future by including functional food monitoring in the new dietary monitoring system in the Netherlands. One specific form of monitoring could be an Internet-based

Hepatitis C in haemorrhagic obstetrical emergencies

International Nuclear Information System (INIS)

Khaskheli, M.; Baloch, S.

2014-01-01

Objective: To determine the maternal health and fetal outcome in hepatitis C with obstetrical haemorrhagic emergencies. Study Design: An observational study. Place and Duration of Study: Department of Obstetrics and Gynaecology Unit-I, Liaquat University of Medical and Health Sciences Hospital, Hyderabad, Sindh, from January 2009 to December 2010. Methodology: All the women admitted during the study period with different obstetrical haemorrhagic emergencies were included. On virology screening, hepatitis C screening was done on all. The women with non-haemorrhagic obstetrical emergencies were excluded. Studied variables included demographic characteristics, the nature of obstetrical emergency, haemorrhagic conditions and maternal and fetal morbidity and mortality. The data was analyzed on SPSS version 20. Results: More frequent obstetrical haemorrhagic emergencies were observed with hepatitis C positive in comparison with hepatitis C negative cases including post-partum haemorrhage in 292 (80.88%) and ante-partum haemorrhage in 69 (19.11%) cases. Associated morbidities seen were disseminated intravascular coagulation in 43 (11.91%) and shock in 29 (8.03%) cases with hepatitis C positive. Fetal still birth rate was 37 (10.24%) in hepatitis C positive cases. Conclusion: Frequency of maternal morbidity and mortality and perinatal mortality was high in obstetrical haemorrhagic emergencies with hepatitis C positive cases. (author)

Dutch Dwellings

NARCIS (Netherlands)

Vries, de B.; Zee, van der A.; Carp, J.C.; Soddu, C.

2004-01-01

Applying Generative Design (GD) for dwelling is not very common but it opens up the possibility to study whether GD systems can reproduce existing design typologies. Dutch dwellings as an exemplification of a design typology are analysed using the SAR methodology. Building regulations are used as

Modelling climate change effects on a dutch coastal groundwater system using airborne electromagnetic measurements

NARCIS (Netherlands)

Faneca S̀anchez, M.; Gunnink, J.L.; Baaren, E.S. van; Oude Essink, G.H.P.; Siemon, B.; Auken, E.; Elderhorst, W.; Louw, P.G.B. de

2012-01-01

The forecast of climate change effects on the groundwater system in coastal areas is of key importance for policy makers. The Dutch water system has been deeply studied because of its complex system of low-lying areas, dunes, land won to the sea and dikes, but nowadays large efforts are still being

Obstetric and gynecologic imaging

International Nuclear Information System (INIS)

Wicks, J.D.

1987-01-01

Obstetric and gynecologic imaging has undergone marked changes in the past 10 years, primarily because of the influence of new imaging modalities. The single modality that has most significantly changed the diagnostic approach to obstetric and gynecologic problems is diagnostic ultrasound. The remarkable ability of this technique to display the anatomy of the gravid and nongravid female pelvis without the use of ionizing radiation motivated the development of techniques and instrumentation that have supplanted but not totally replaced many x-ray based examinations. The use of diagnostic ultrasound for the evaluation of obstetric and gynecologic problems is the dominant theme of this chapter. Areas of patient diagnosis and management in which additional imaging techniques, x-rays, or magnetic resonance are used are presented where appropriate

Obstetrical ultrasound

International Nuclear Information System (INIS)

Bundy, A.L.

1988-01-01

The use of diagnostic ultrasound in obstetrics may provide fuel for legal action. While most legal implications of this relatively new imaging modality are purely speculative, some have already given rise to legal action. Several situations will likely provide a basis for the courts to find against the physician. The failure to perform a sonogram when clinically indicated will most likely be the strongest plaintiff argument. Other major concerns include the use and availability of state-of-the-art equipment, as well as interpretation of the scans by a trained physician. Obstetrical ultrasound is usually performed by a radiologist or obstetrician. However, many physicians performing these examinations have had little or no formal training in the field. While this is now being remedied by the respective board examines who require a certain amount of training, it may not be enough. When ultrasound-related cases reach the courts, the involved physicians will most likely be regarded as experts in the field and, therefore, will be held to a very high standard of care. This would be difficult to achieve without formal training. At the present time, the American Board of Radiology requires more training time in ultrasound than the American Board of Obstetrics and Gynecology

Barriers to formal emergency obstetric care services' utilization.

Science.gov (United States)

Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

2011-06-01

Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be

77 FR 19967 - Safety Zone, Port of Dutch Harbor; Dutch Harbor, AK

Science.gov (United States)

2012-04-03

...-AA00 Safety Zone, Port of Dutch Harbor; Dutch Harbor, AK AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking. SUMMARY: The Coast Guard proposes temporary safety zones in the Port of Dutch Harbor... Dutch Harbor, Alaska, and the adjacent territorial sea due to additional vessel traffic associated with...

Midwives and obstetric nurses in the Brazilian Unified Health System and Primary Health Care: for a systemic and progressive incorporation

OpenAIRE

Armando Henrique Norman; Charles Dalcanale Tesser

2015-01-01

The objective of this paper is to present a proposal for a gradual and systemic incorporation of midwives and obstetric nurses into the Brazilian Unified Health System (SUS) and Primary Health Care (PHC). The proposal was born from contact with the British experience, based on midwives, which is briefly described. In Brazil, these professionals would progressively take over the prenatal, delivery and postpartum care for pregnant women of usual risk in a region, in partnership with the PHC tea...

Obstetric medicine: Interlinking obstetrics and internal medicine

African Journals Online (AJOL)

1 Mayo Clinic Hospitals, Division of Hospital Internal Medicine, Rochester, Minn, USA ... Obstetric physicians have a specific role in managing pregnant and postpartum women with ... problems may also affect pregnancy outcomes, with increased risk of ... greatly benefited from good control of her diabetes and hypertension.

21 CFR 884.5100 - Obstetric anesthesia set.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric anesthesia set. 884.5100 Section 884... § 884.5100 Obstetric anesthesia set. (a) Identification. An obstetric anesthesia set is an assembly of... anesthetic drug. This device is used to administer regional blocks (e.g., paracervical, uterosacral, and...

The Dutch pork chain: a commodity system resisting threats from the market and society

NARCIS (Netherlands)

Greef, de K.H.; Casabianca, F.

2009-01-01

The Dutch pork sector can be characterized as one massive, homogeneous commodity system, resisting diversification. A closer look at innovation strategies and initiatives leads to the conclusion that efforts are being made to enhance sustainability (including economic viability) through

Managing Recurring Obstetric Cholestasis With Metformin.

Science.gov (United States)

Elfituri, Abdullatif; Ali, Amanda; Shehata, Hassan

2016-12-01

Obstetric cholestasis is a pregnancy-related disorder associated with an adverse pregnancy outcome. It is characterized by generalized pruritus, elevated bile acids, and abnormal liver enzymes. Recent publications show that obstetric cholestasis is associated with, and likely to potentiate, the risk of developing gestational diabetes mellitus. This case describes an unusual pattern of the disease, in which obstetric cholestasis occurred in five consecutive pregnancies with a different course of the disease in the fifth pregnancy. A patient with recurrent cholestasis of pregnancy had worsening disease in her first four pregnancies. In her fifth pregnancy, treatment for gestational diabetes mellitus with metformin was associated with a lowering effect on bile acids and liver enzymes, indicating a possible role for metformin in the management of obstetric cholestasis.

Prevalence of claw disorders in Dutch dairy cows exposed to several floor systems

NARCIS (Netherlands)

Somers, J.G.C.J.; Frankena, K.; Noordhuizen-Stassen, E.N.; Metz, J.H.M.

2003-01-01

Claw health was examined in an observational study on Dutch dairy farms with either a slatted floor (SL), slatted floor with manure scraper (SL-SCR), solid concrete floor (SCF), a straw yard (SY), or a zero-grazing feeding system (ZG). Hooves of cows' hind legs were examined for the presence and

Obstetric care in Brazil: An analysis of the situation

Directory of Open Access Journals (Sweden)

Marcia de Freitas

2006-03-01

Full Text Available Objective: To evaluate the situation of obstetric care in Brazil. Methods:Analysis of data from the Ministry of Health: Information System onMortality; Information System on Live Births; Information System onAmbulatory Care of the Brazilian Unified Health System; InformationSystem on Hospital Care of the Brazilian Unified Health System. Otherssource of data: the Brazilian Institute of Geography and Statistics.Results: Maternal mortality rate was 50.83/100000 live births in Brazil.Prenatal care in the Northern and Northeastern regions of the countrypresented the lowest number of prenatal care appointments (27% ofpregnant women with less than 3 appointments. Premature labor wasthe main diagnosis for hospital admission before delivery. The numberof obstetric beds exceeds the population demand throughout the country.The main causes of maternal deaths were direct causes. Conclusions:Maternal mortality rate in Brazil is high and the main causes of deathsare preventable and related to medical and non-medical factors.

Tropical Journal of Obstetrics and Gynaecology

African Journals Online (AJOL)

reviewed journal. The Journal is Official Publication of Society of Gynaecology and Obstetrics of Nigeria. The journal publishes articles on the subject it provides a forum for the publication of original articles Obstetrics, Gynaecology, ...

Ethnic identity, externalizing problem behaviour and the mediating role of self-esteem among Dutch, Turkish-Dutch and Moroccan-Dutch adolescents

NARCIS (Netherlands)

Wissink, I.B.; Deković, M.; Yağmur, S.; Stams, G.J.; de Haan, M.

2008-01-01

The present study examined whether self-esteem mediates the relationship between two aspects of ethnic identity (i.e. ethnic identity exploration and ethnic identity commitment-affirmation) and externalizing problem behaviour in Dutch, Turkish-Dutch and Moroccan-Dutch adolescents living in the

Het Nederlands signaleringscentrum kindergeneeskunde; een kwaliteitsinstrument voor preventie en onderzoek [The Dutch Paediatric Surveillance System; a quality-focused instrument for prevention and research

NARCIS (Netherlands)

Hirasing, R.A.; Rodrigues Pereira, R.

2002-01-01

The Dutch Paediatric Surveillance System was initiated by the Dutch Paediatric Society and is housed within the TNO Prevention and Health office. The purpose of the surveillance system is (a) to gain insight on a population level into the prevalence of rare and new diseases in youths (0-18 year),

Migrants and obstetrics in Austria--applying a new questionnaire shows differences in obstetric care and outcome.

Science.gov (United States)

Oberaigner, Willi; Leitner, Hermann; Oberaigner, Karin; Marth, Christian; Pinzger, Gerald; Concin, Hans; Steiner, Horst; Hofmann, Hannes; Wagner, Teresa; Mörtl, Manfred; Ramoni, Angela

2013-01-01

Immigration plays a major role in obstetrics in Austria, and about 18 % of the Austrian population are immigrants. Therefore, we aimed to (1) test the feasibility of a proposed questionnaire for assessment of migrant status in epidemiological research and (2) assess some important associations between procedures and outcomes in obstetrics and migration in selected departments in Austria. We adapted a standardized questionnaire to the main immigration groups in Austria. Information on country of origin, length of residence in Austria and German-language ability was collected from eight selected obstetrics departments. Of the 1,971 questionnaires, 1,873 questionnaires of singleton births were selected and included in the analysis. We analyzed a total of 1,873 parturients with singleton births, of which 35 % had migrant status, 12 % were from ex-Yugoslavia, 12 % were from Turkey, and 12 % were from other countries. The proportion of parturients having their first care visit after the 12th week of pregnancy was higher in migrant groups (19 %). Smoking was highest in the migrants from ex-Yugoslavia (21 %). Vaginal delivery was more frequent in migrants from ex-Yugoslavia (78 %) and Turkey (83 %) than in nonmigrants (71 %) and episiotomy was more frequently performed in migrants from other countries. All differences are statistically significant. Administration of a standardized questionnaire for assessment of migrant status in obstetric departments in Austria was shown to be feasible. We assessed differences in obstetric care and outcome and consequently recommend that action should be initiated in Austria toward harmonizing obstetric procedures among the migrant and the nonmigrant groups and toward minimizing risk factors.

Do stakeholder groups influence environmental management system development in the Dutch agri-food sector?

NARCIS (Netherlands)

Bremmers, H.J.; Omta, S.W.F.; Kemp, R.G.M.; Haverkamp, D.J.

2007-01-01

This paper presents the results of a survey that included 492 companies in the Dutch agri-food sector with respect to the influence of stakeholder groups on the companies' level of environmental management system (EMS) implementation. It is concluded that primary stakeholders (government, clients)

Association study of obstetrical complication and depressive disorder

Institute of Scientific and Technical Information of China (English)

无

2007-01-01

Objective:To investigate the correlation between obstetrical complications and depressive disorder.Methods:Depressive disorder probands and their adult sibling were diagnosed using CCMD-3 criteria.Obstetrical data from maternal reports were scored,applying published scales that take into account number and severity of complication.Results:The scores of obstetric complication and prenatal complications and low birth weight were significantly worse in probands than siblings without depressive disorders.Conclusion:Results suggest obstetric complications are etiologically significant in depressive disorder.

[A proposal for introduction of Europeristat-compatible information system aiming a unified quality control of obstetrical and perinatological care in Hungary].

Science.gov (United States)

Berkő, Péter

2016-05-01

It is a regrettable deficiency in the Hungarian healthcare that the culture and the system of quality control of cure have not been formed (except for a few subspecialties, units or wards). If hospital wards do not have a national, professionally unified and modern information system presenting the most important quantity and quality indicators of their medicinal activity annually, a stable basis for definition of future tasks is absent. The author puts forward a proposal for the establishment of the information systems for different professional fields. On the basis of experience of perinatological information system operating for over 3 decades in Borsod-Abaúj-Zemplén county, he also proposes introduction of a nationally unified, Europeristat-compatible information system following Tauffer-statistics which may serve as a uniform quality control of obstetrics and perinatological care, as well as introduction of its base, the dataform "TePERA" (Form of Obstetrics and Perinatological Care Risk).

Improving the energy and IAQ performance of ventilation systems in Dutch dwellings

NARCIS (Netherlands)

Holsteijn, R.C.A. van; Li, W.L.; Valk, H.J.J.; Kornaat, W.

2016-01-01

MONICAIR - MONItoring & Control of Air quality in Individual Rooms - is a pre-competitive field research project of a broad consortium of Dutch ventilation unit manufacturers and research institutes, supported by the Dutch government. The first aim of the project is to investigate and compare the

Pattern and determinants of obstetric complications among women ...

African Journals Online (AJOL)

The number of antenatal care visits also significantly predicted the likelihood of obstetric complications. Binomial logistic regression analysis predicted that the more the number of antenatal care visits the less likely the occurrence of obstetric complications, with 4 or more visits reducing obstetric complications 14 times.

Improved obstetric safety through programmatic collaboration.

Science.gov (United States)

Goffman, Dena; Brodman, Michael; Friedman, Arnold J; Minkoff, Howard; Merkatz, Irwin R

2014-01-01

Healthcare safety and quality are critically important issues in obstetrics, and society, healthcare providers, patients and insurers share a common goal of working toward safer practice, and are continuously seeking strategies to facilitate improvements. To this end, 4 New York City voluntary hospitals with large maternity services initiated a unique collaborative quality improvement program. It was facilitated by their common risk management advisors, FOJP Service Corporation, and their professional liability insurer, Hospitals Insurance Company. Under the guidance of 4 obstetrics and gynecology departmental chairmen, consensus best practices for obstetrics were developed which included: implementation of evidence based protocols with audit and feedback; standardized educational interventions; mandatory electronic fetal monitoring training; and enhanced in-house physician coverage. Each institution developed unique safety related expertise (development of electronic documentation, team training, and simulation education), and experiences were shared across the collaborative. The collaborative group developed robust systems for audit of outcomes and documentation quality, as well as enforcement mechanisms. Ongoing feedback to providers served as a key component of the intervention. The liability carrier provided financial support for these patient safety innovations. As a result of the interventions, the overall AOI for our institutions decreased 42% from baseline (January-June 2008) to the most recently reviewed time period (July-December 2011) (10.7% vs 6.2%, p Risk Management of the American Hospital Association.

Perceived antecedents of marital satisfaction among Turkish, Turkish-Dutch, and Dutch couples.

Science.gov (United States)

Celenk, Ozgur; van de Vijver, Fons J R

2013-01-01

We studied mainstream couples in The Netherlands and Turkey as well as Turkish-Dutch immigrant couples to address cultural factors associated with marital satisfaction. A total of 13 Turkish (mainstream couples living in Turkey), 19 Turkish-Dutch (Turkish immigrant couples living in The Netherlands), and 17 Dutch (mainstream couples living in The Netherlands) married dyads (total of 98 individuals) were independently interviewed about positive and negative characteristics of marriages, determinants of general marital satisfaction and dissatisfaction, spousal communication, marital conflict, and marital roles. Multivariate tests revealed ethnic group differences on all marriage-related domains except the conflict resolution strategies. However, univariate analyses showed differences in few themes within domains; main differences were assessed between the Turkish/Turkish-Dutch (who put more emphasis on children and economical aspects) and Dutch couples (who put more emphasis on behavior, and personality of the spouse, reciprocity, emotional sharing, and psychological roles). Turkish-Dutch couples were more similar to Turkish than to Dutch couples. Results were discussed in light of the socioeconomic development and cultural value theories, which are believed to provide a useful framework for understanding the role of culture in marital satisfaction.

Ethnic Identity, Externalizing Problem Behaviour and the Mediating Role of Self-Esteem among Dutch, Turkish-Dutch and Moroccan-Dutch Adolescents

Science.gov (United States)

Wissink, Inge B.; Dekovic, Maja; Yagmur, Sengul; Stams, Geert Jan; de Haan, Mariette

2008-01-01

The present study examined whether self-esteem mediates the relationship between two aspects of ethnic identity (i.e. ethnic identity exploration and ethnic identity commitment-affirmation) and externalizing problem behaviour in Dutch, Turkish-Dutch and Moroccan-Dutch adolescents living in the Netherlands. A total number of 345 adolescents (115…

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics*

OpenAIRE

Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

2015-01-01

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent ...

Resistance of Mayan Women against Obstetric Violence

OpenAIRE

Gonzalez-Flores, Marina

2015-01-01

Mayan women are often victims of obstetric violence in the Yucatan Peninsula. Obstetric violence is defined as violence women experience by health officials or midwives during birth. This article will examine five different communities within the states of Yucatan, Campeche, and Quintana Roo in Mexico and compare and contrast activism efforts against obstetric violence among Mayan women. Mayan women are organizing to create unions for midwives, workshops on reproductive rights and health care...

Ultrasonography in obstetrics and gynecology, 2nd edition

International Nuclear Information System (INIS)

Callen, P.W.

1988-01-01

A text on obstetric and gynecologic ultrasound for radiologists, OB/GYN practitioners, and radiologic technicians. The second edition places greater emphasis on diagnosis of specific systemic disorders in the fetus, as well as the most current applications of ultrasound in gynecologic diagnosis

The impact of microgeneration upon the Dutch balancing market

NARCIS (Netherlands)

Van der Veen, R.A.C.; De Vries, L.J.

2009-01-01

The share of microgeneration (power generation at the level of households and small businesses) in the Dutch electricity system continues to grow. Over time, this development may pose a threat to the reliability and efficiency of the Dutch electricity balancing market. We investigated possible

Euthanasia in the Broader Framework of Dutch Penal Policies

NARCIS (Netherlands)

Groenhuijsen, M.S.; van Laanen, F.; Groenhuijsen, M.S.; van Laanen, F.

2006-01-01

The authors have regarded euthanasia in the broader framework of Dutch penal policies. They present euthanasia as a typical example of the pragmatic - rather than dogmatic - way the Dutch try to tackle difficult moral problems in connection with the criminal justice system. Definitions, statutory

OBSTETRIC RENAL FAILURE

Directory of Open Access Journals (Sweden)

Rajeshwari

2015-11-01

Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

Obstetric Performance Recallaccuracy (OPERa) amonga low ...

African Journals Online (AJOL)

Nigerian Journal of Clinical Practice ... Accurate obstetric history is of utmost importance in prenatal care to ensure optimal maternal fetal outcomes. ... Primiparous and multiparous women, who accessed antenatal care in a rural Mission Hospital over a two-year period, had their past obstetric histories recorded in a pro ...

The Dutch Banking Chipcard Game

NARCIS (Netherlands)

H.J. de Vries (Henk); G.W.J. Hendrikse (George)

2001-01-01

textabstractThe banks in the Dutch chipcard market initially agreed on one chipcard system. One system is attractive for companies as well as consumers. Companies, banks and retailers, prevent costs of duplication, while consumers enjoy the benefits of a widespread acceptance of one card and do not

The economic impact of rural family physicians practicing obstetrics.

Science.gov (United States)

Avery, Daniel M; Hooper, Dwight E; McDonald, John T; Love, Michael W; Tucker, Melanie T; Parton, Jason M

2014-01-01

The economic impact of a family physician practicing family medicine in rural Alabama is $1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986. Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed. Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%. A family physician practicing obstetrics in a rural area adds an additional $488,560 in economic benefit to the community in addition to the $1,000,000 from practicing family medicine, producing a total annual benefit of $1,488,560. The investment of $616,385 from the Alabama Family Practice Rural Health Board resulted in a $399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was $246,047,120. © Copyright 2014 by the American Board of Family Medicine.

Best broiler husbandry system and perceived importance of production aspects by Dutch citizens, poultry farmers and veterinarians

NARCIS (Netherlands)

Asselt, van M.; Ekkel, E.D.; Kemp, B.; Stassen, E.N.

2015-01-01

The objectives of this study were to explore the views of Dutch citizens, poultry farmers and poultry veterinarians regarding: (1) best broiler husbandry systems; (2) the importance of production aspects of broiler production and (3) the relation between best husbandry system and the importance of

Applying systems engineering in the civil engineering industry : an analysis of systems engineering projects of a Dutch water board

NARCIS (Netherlands)

de Graaf, R. S. (Robin); Vromen, R. M.(Rick); Boes, J. (Hans)

2017-01-01

The past decade, practice and literature have shown an increasing interest in Systems Engineering (SE) in the civil engineering industry. The aim of this study is to analyse to what extent SE is applied in six civil engineering SE projects of a Dutch water board. The projects were analysed using a

Obstetric complications: does training traditional birth attendants make a difference?

Directory of Open Access Journals (Sweden)

Patricia E. Bailey

2002-01-01

Full Text Available Objective. To assess the effect that a training intervention for traditional birth attendants (TBAs in Guatemala had on the detection of obstetric complications, the referral of patients with complications to the formal health care system, and, ultimately, those patients' utilization of essential obstetric care services. Methods. Using a quasi-experimental design, a surveillance system of births was implemented to collect population-based information from 3 518 women between 1990 and 1993. All women were interviewed postpartum by physicians. There were three key independent variables in our study: 1 geographical area (intervention community and non-intervention community, 2 time in relation to the training intervention (before or after, and 3 presence or absence of a TBA at the time of the complication. The key dependent variables for women interviewed were 1 development of an obstetric complication, 2 detection of the problem by the TBA, 3 referral to a health facility, 4 compliance with referral, and 5 use of services. Results. The incidence of postpartum complications decreased after the intervention, controlling for intervention community. On the other hand, after the intervention TBAs were less likely to recognize most maternal complications, and referral rates did not increase significantly. The likelihood of using health care services increased six-fold among women who were not attended by TBAs, and no increase was observed among those who were attended by TBAs. Conclusion. Training TBAs may have had a positive effect on the rate, detection, and referral of postpartum complications. However, the evidence is less convincing for overall increases in the detection of complications, in referral to the formal health care system, and in the utilization of essential obstetric services among women attended by TBAs.

Practice variation in the Dutch long-term care and the role of supply-sensitive care: Is access to the Dutch long-term care equitable?

Science.gov (United States)

Duell, Daisy; Koolman, Xander; Portrait, France

2017-12-01

Universal access and generous coverage are important goals of the Dutch long-term care (LTC) system. It is a legal requirement that everyone eligible for LTC should be able to receive it. Institutional care (IC) made up for 90% of Dutch LTC spending. To investigate whether access to IC is as equitable as the Dutch government aspires, we explored practice variation in entitlements to IC across Dutch regions. We used a unique dataset that included all individual applications for Dutch LTC in January 2010-December 2013 (N = 3,373,358). This dataset enabled an accurate identification of the need for care. We examined the local variation in the probability of being granted long-term IC and in the intensity of the care granted given that individuals have applied for LTC. We also investigated whether the variation observed was related to differences in the local availability of care facilities. Although our analyses indicated the presence of some practice variation, its magnitude was very small by national and international standards (up to 3%). Only a minor part of the practice variation could be accounted for by local supply differences in care facilities. Overall, we conclude that, unlike many other developed countries, the Dutch system ensured equitable access to long-term IC. © 2017 The Authors. Health Economics Published by John Wiley & Sons Ltd.

[Burnout syndrome in medical and obstetric perception of violence].

Science.gov (United States)

Pintado-Cucarella, Sheila; Penagos-Corzo, Julio C; Casas-Arellano, Marco Antonio

2015-03-01

Obstetric violence involves a violation of reproductive rights of women during pregnancy, childbirth and postpartum. It has been associated with lack of empathy and emotional discomfort of physicians. To identify the perceptions of obstetric violence and to determine the possible relationship with burnout syndrome. We evaluated 29 physicians whose scope of work relates to obstetrics and gynecology. The evaluation instruments were: a) questionnaire on professional perception that collects demographic information, situations of perceived obstetric violence, major concerns of physicians in their professional work, and includes an scale about level of job satisfaction, b) the Maslach Burnout inventory, and c) Jefferson Scale of Physician Empathy. The most prevalent obstetric violence situations perceived were: medical malpractice and harmful practices (10/29), discrimination (10/29), rude treatment and verbal attacks (11/29). Seventeen participants reported lack of information on obstetric violence and not have tools to cope with this problem. Regarding the burnout syndrome, it was associated with several items of the scale of empathy and with the scale of job satisfaction. This study shows the importance of providing knowledge and tools to deal with obstetric violence and stress management to prevent such situations on medical practices.

Obstetric spinal hypotension: Preoperative risk factors and the ...

African Journals Online (AJOL)

Obstetric spinal hypotension: Preoperative risk factors and the development of a preliminary risk score – the PRAM score. ... We used empirical cut-point estimations in a logistic regression model to develop a scoring system for prediction of hypotension. Results. From 504 eligible patients, preoperative heart rate (odds ratio ...

Obstetric Thromboprophylaxis: The Swedish Guidelines

Directory of Open Access Journals (Sweden)

Pelle G. Lindqvist

2011-01-01

Full Text Available Obstetric thromboprophylaxis is difficult. Since 10 years Swedish obstetricians have used a combined risk estimation model and recommendations concerning to whom, at what dose, when, and for how long thromboprophylaxis is to be administrated based on a weighted risk score. In this paper we describe the background and validation of the Swedish guidelines for obstetric thromboprophylaxis in women with moderate-high risk of VTE, that is, at similar or higher risk as the antepartum risk among women with history of thrombosis. The risk score is based on major risk factors (i.e., 5-fold increased risk of thromboembolism. We present data on the efficacy of the model, the cost-effectiveness, and the lifestyle advice that is given. We believe that the Swedish guidelines for obstetric thromboprophylaxis aid clinicians in providing women at increased risk of VTE with effective and appropriate thromboprophylaxis, thus avoiding both over- and under-treatment.

FOETOMATERNAL OUTCOME OF OBSTETRIC CHOLESTASIS

Directory of Open Access Journals (Sweden)

Nina Mishra

2017-07-01

Full Text Available BACKGROUND Obstetric cholestasis is a disorder of liver function commonly occurring in the third trimester of pregnancy. Clinical characters of this disorder include unexplained maternal pruritus, most common site being palms and soles, altered liver functions (elevated serum transaminases and increased fasting serum bile acids (>10 micro mol/L in previously healthy pregnant women. The incidence is variable geographically from 0.1% to 15.6% all over the world. The aetiology of this condition is not fully understood. Its pathogenesis is related to increased sex hormone synthesis, environmental factors and genetic predisposition. Obstetric cholestasis can lead to increased foetal morbidity and mortality with regards to preterm delivery, neonatal respiratory distress syndrome, foetal distress and sudden intrauterine foetal death. Treatment of the disease focus on relieving symptoms and signs. The aim of the study is to evaluate the pregnancy and foetal outcome of pregnant women with obstetric cholestasis. MATERIALS AND METHODS A cross-sectional study was conducted in M.K.C.G. Medical College and Hospital, Berhampur from February 2015 to May 2017. Inclusion Criteria- All patients having pruritus during course of pregnancy with biochemical evidence of raised liver function tests attending antenatal clinic or labour room. Exclusion Criteria- 1 Pregnant women without pruritus; 2 Pregnant women having other liver diseases. RESULTS The incidence of obstetric cholestasis was 0.6%. Majority of cases were primigravida (72.9%. Positive family history was present in 11.4% of cases. Majority of cases (77.1% had normal vaginal delivery. 22.9% of cases had caesarean section. Primary postpartum haemorrhage occurred in only 2.9% of cases. CONCLUSION Obstetric cholestasis can be managed by improving the circulating bile acid level, targeting the cause of pruritus and optimising the time of delivery as a result of which we can reduce adverse pregnancy outcomes.

Will Dutch Become Flemish? Autonomous Developments in Belgian Dutch

Science.gov (United States)

Van de Velde, Hans; Kissine, Mikhail; Tops, Evie; van der Harst, Sander; van Hout, Roeland

2010-01-01

In this paper a series of studies of standard Dutch pronunciation in Belgium and the Netherlands is presented. The research is based on two speech corpora: a diachronic corpus of radio speech (1935-1995) and a synchronic corpus of Belgian and Netherlandic standard Dutch from different regions at the turn of the millennium. It is shown that two…

Can private obstetric care be saved in South Africa

Directory of Open Access Journals (Sweden)

Graham Howarth

2014-11-01

Full Text Available This article examines the question of whether private obstetric care in South Africa (SA can be saved in view of the escalation in medical and legal costs brought about by a dramatic increase in medical negligence litigation. This question is assessed with reference to applicable medical and legal approaches. The crux of the matter is essentially a question of affordability. From a medical perspective, it seems that the English system (as articulated by the Royal College of Obstetricians and Gynaecologists as well as American perspectives may be well suited to the SA situation. Legal approaches are assessed in the context of the applicable medicolegal framework in SA, the present nature of damages and compensation with reference to obstetric negligence liability, as well as alternative options (no-fault and capping of damages to the present system based on fault. It is argued, depending on constitutional considerations, that a system of damages caps for noneconomic damages seems to be the most appropriate and legally less invasive system in conjunction with the establishment of a state excess insurance fund.

Dutch ministerial visit

CERN Multimedia

2007-01-01

Dutch Minister of Education, Culture and Science R. Plasterk (third from left) in the ATLAS cavern with NIKHEF Director F. Linde, CERN Chief Scientific Officer J. Engelen, Ambassador J. van Eenennaam, ATLAS Collaboration Spokesperson P. Jenni, Mission Representative G. Vrielink and ATLAS Magnet Project Leader H. ten Kate.Minister of Education, Culture and Science from the Kingdom of the Netherlands, Ronald Plasterk, visited CERN on 25th October. With Jos Engelen, CERN Scientific Director, as his guide he visited Point 1 of the LHC tunnel and ATLAS, where Nikhef (the national institute for subatomic physics, a Dutch government and university collaboration) constructed all 96 of the largest muon drift chambers in the barrel as well as parts of the magnet system, the inner detector, the DAQ and triggering. Overall the Netherlands contribute 4.5% to the annual CERN budget and the minister’s visit celebrated the contributions of the 79 ...

Emergency preparedness in obstetrics.

Science.gov (United States)

Haeri, Sina; Marcozzi, David

2015-04-01

During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future.

The critically ill obstetric patient - Recent concepts

Directory of Open Access Journals (Sweden)

Anjan Trikha

2010-01-01

Full Text Available Obstetric patients admitted to an Intensive Care Unit (ICU present a challenge to an intensivist because of normal physiological changes associated with pregnancy and puerperium, the specific medical diseases peculiar to pregnancy and the need to take care of both the mother and the foetus. Most common causes of admission to an ICU for obstetric patients are eclampsia, severe preeclampsia, haemorrhage, congenital and valvular heart disease, septic abortions, severe anemia, cardiomyopathy and non-obstetric sepsis. The purpose of this review is to present the recent concepts in critical care management of obstetric patients with special focus mainly on ventilatory strategies, treatment of shock and nutrition. The details regarding management of individual diseases would not be discussed as these would be beyond the purview of this article. In addition, some specific issues of importance while managing such patients would also be highlighted.

Obstetric acute renal failure 1956-1987.

Science.gov (United States)

Turney, J H; Ellis, C M; Parsons, F M

1989-06-01

A total of 142 women with severe acute renal failure (ARF) resulting from obstetric causes was treated by dialysis at a single centre from 1956 to 1987. One-year survival was 78.6%, which compares favourably with other causes of ARF. Abortion, haemorrhage and preclampsia comprised 95% of cases, with survival being best (82.9%) with abortion. Survival was adversely affected by increasing age. Acute cortical necrosis (12.7% of patients) carried 100% mortality after 6 years. Follow-up of survivors showed normal renal function up to 31 years following ARF; 25-year patient survival was 71.6%. Improvements in obstetric care and the disappearance of illegal abortions have resulted in a dramatic decline in the incidence of obstetric ARF.

EMERGO : The Dutch flood risk system since 1986

NARCIS (Netherlands)

Rijcken, T.

2017-01-01

PART I | A RESEARCH AND DESIGN PROJECT ABOUT FLOOD RISK POLICY SINCE 1986 The period between the Dutch flood disaster of 1953 and the year 2016 can be divided into two eras, separated by the year 1986, when the famous Eastern Scheldt barrier was completed. The perspective of water professionals on

Journal of Obstetrics and Gynaecology of Eastern and Central Africa

African Journals Online (AJOL)

JOGECA) is a peer reviewed quarterly journal published by Kenya Obstetrical and Gynaecological Society (KOGS). It publishes: original work in all aspects related to obstetrics and gynaecology, reviews related to obstetrics and gynaecology and ...

A multi disciplinary obstetric emergency training programme.

LENUS (Irish Health Repository)

Whelan, Mary

2012-09-01

The Rotunda Hospital (Dublin) obstetric emergency training programme (RHOET) was designed, in 2008, to meet the ongoing education and training needs of the local multidisciplinary team. Prior to its implementation, senior midwives attended the advanced life support in obstetrics (ALSO) course, and many of the obstetricians attended the Management of obstetric emergencies and trauma (MOET) and\\/or ALSO courses. Attendance at these off site courses meant that the only opportunity for team training was the informal and ad hoc \\'drills and skills\\' that took place in the birthing suite. This paper documents our journey since RHOET was implemented.

[Obstetric analgesia and anesthesia in Switzerland in 1999].

Science.gov (United States)

Zwetsch-Rast, G; Schneider, M C; Siegemund, M

2002-02-01

This survey investigated the common practice of obstetric analgesia and anaesthesia in Swiss hospitals and evaluated the influence of the Swiss interest group for obstetric anaesthesia. In March 1999 we submitted 145 questionnaires to all Swiss hospitals providing an obstetric service. The rate of epidural analgesia (EA) was higher in large hospitals (> 1,000 births/year) than in small services. EA was maintained by continuous infusion techniques in 53% of the responding hospitals. For elective caesarean section, spinal anaesthesia (SA) and EA were performed in 77% and 16% of the patients, respectively. General anaesthesia (5%) was only used in small hospitals (interest group for obstetric anaesthesia, as well as the expectations of pregnant women, increased the numbers of regional anaesthesia compared with the first survey in 1992.

The design of PoliDocs: a web information system for the disclosure of Dutch parliamentary publications

NARCIS (Netherlands)

Gielissen, T.; Marx, M.

2009-01-01

The development of PoliDocs.nl, a Web Information System for the disclosure of Dutch parliamentary publications, is an effort to improve the disclosure of parliamentary publications in The Netherlands. The data is distributed over three sources and is available through different Web Information

Cost Analysis of Various Low Pathogenic Avian Influenza Surveillance Systems in the Dutch Egg Layer Sector

NARCIS (Netherlands)

Rutten, N.; Gonzales, J.L.; Elbers, A.R.; Velthuis, A.G.J.

2012-01-01

Background As low pathogenic avian influenza viruses can mutate into high pathogenic viruses the Dutch poultry sector implemented a surveillance system for low pathogenic avian influenza (LPAI) based on blood samples. It has been suggested that egg yolk samples could be sampled instead of blood

Simulation laboratories for training in obstetrics and gynecology.

Science.gov (United States)

Macedonia, Christian R; Gherman, Robert B; Satin, Andrew J

2003-08-01

Simulations have been used by the military, airline industry, and our colleagues in other medical specialties to educate, evaluate, and prepare for rare but life-threatening scenarios. Work hour limits for residents in obstetrics and gynecology and decreased patient availability for teaching of students and residents require us to think creatively and practically on how to optimize their education. Medical simulations may address scenarios in clinical practice that are considered important to know or understand. Simulations can take many forms, including computer programs, models or mannequins, virtual reality data immersion caves, and a combination of formats. The purpose of this commentary is to call attention to a potential role for medical simulation in obstetrics and gynecology. We briefly describe an example of how simulation may be incorporated into obstetric and gynecologic residency training. It is our contention that educators in obstetrics and gynecology should be aware of the potential for simulation in education. We hope this commentary will stimulate interest in the field, lead to validation studies, and improve training in and the practice of obstetrics and gynecology.

Dutch-Flemish translation of nine pediatric item banks from the Patient-Reported Outcomes Measurement Information System (PROMIS)®.

Science.gov (United States)

Haverman, Lotte; Grootenhuis, Martha A; Raat, Hein; van Rossum, Marion A J; van Dulmen-den Broeder, Eline; Hoppenbrouwers, Karel; Correia, Helena; Cella, David; Roorda, Leo D; Terwee, Caroline B

2016-03-01

The Patient-Reported Outcomes Measurement Information System (PROMIS(®)) is a new, state-of-the-art assessment system for measuring patient-reported health and well-being of adults and children. It has the potential to be more valid, reliable, and responsive than existing PROMs. The items banks are designed to be self-reported and completed by children aged 8-18 years. The PROMIS items can be administered in short forms or through computerized adaptive testing. This paper describes the translation and cultural adaption of nine PROMIS item banks (151 items) for children in Dutch-Flemish. The translation was performed by FACITtrans using standardized PROMIS methodology and approved by the PROMIS Statistical Center. The translation included four forward translations, two back-translations, three independent reviews (at least two Dutch, one Flemish), and pretesting in 24 children from the Netherlands and Flanders. For some items, it was necessary to have separate translations for Dutch and Flemish: physical function-mobility (three items), anger (one item), pain interference (two items), and asthma impact (one item). Challenges faced in the translation process included scarcity or overabundance of possible translations, unclear item descriptions, constructs broader/smaller in the target language, difficulties in rank ordering items, differences in unit of measurement, irrelevant items, or differences in performance of activities. By addressing these challenges, acceptable translations were obtained for all items. The Dutch-Flemish PROMIS items are linguistically equivalent to the original USA version. Short forms are now available for use, and entire item banks are ready for cross-cultural validation in the Netherlands and Flanders.

Dutch School in Geneva

CERN Multimedia

2011-01-01

The Dutch School in Geneva organizes Dutch education for children in the primary and secondary school. For the school year 2011-2012 the Dutch School in Geneva is looking for qualified part time teachers Dutch for the primary and secondary school. If you are interested, please send your application and curriculum vitae in Dutch by email to the NTC coordinator, Mrs. Anne Saeys (anne.saeys@free.fr). More info : www.ntcgeneve.info De vereniging Nederlandse Taal en Cultuur De Taalfontein, kortweg NTC Genève, is een oudervereniging, die tot doel heeft de Nederlandse taal en de Nederlandse en Vlaamse cultuur in de regio Genève te stimuleren. Dit geschiedt d.m.v. het organiseren van Nederlandse les voor leerlingen zowel in het basisonderwijs als het voortgezet onderwijs. Voor het volgende schooljaar zoekt NTC parttime docenten (M/V) vanaf 2 uur per week, zowel voor het Primair Onderwijs als voor het Voortgezet Onderwijs, met name voor de IB-opleiding. Voor het Primair Onderwijs dienen ge&...

Barriers to emergency obstetric care services

DEFF Research Database (Denmark)

Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique

2014-01-01

Introduction: Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore...... barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. Methods: A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced...... decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay...

Integration of wind energy in the Dutch electricity system in the context of the Northwestern European market for electricity. Final report

International Nuclear Information System (INIS)

Benz, E.; Hewicker, C.; Moldovan, N.; Stienstra, G.; Van der Veen, W.

2010-04-01

A study was conducted of the integration of large volumes of wind energy in the Dutch electricity system in the context of a Northwest European electricity market for the year 2020. This study contributes to answering the questions that are at the centre of the project 'Fuel mix'. The following aspects are addressed: the capacity to combine large volumes of wind energy in the Dutch electricity system with the use of CHP; the impact of electricity costs; the influence on CO2 emissions and fuel use; the correlation between the electricity production of CHP units; wind parks and coal-fired plants. In this study the Dutch electricity system is simulated in connection with the framework of the regional electricity market in Northwest Europe for the year 2020. The conducted simulations are based on perfect competition with the marginal cost price of the production units as offer price in the electricity market. To this end the chronological production simulation model (PLEXOS) was used, which takes into account the dynamic operational management and limitations of the electricity plants and the transmission grid. [nl

Using Web-Based Questionnaires and Obstetric Records to Assess General Health Characteristics Among Pregnant Women: A Validation Study.

Science.gov (United States)

van Gelder, Marleen M H J; Schouten, Naomi P E; Merkus, Peter J F M; Verhaak, Chris M; Roeleveld, Nel; Roukema, Jolt

2015-06-16

Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history are scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this parameter in large populations. The aim of this study was to assess the validity of a Web-based questionnaire on chronic medical conditions, allergies, and blood pressure readings against obstetric records and data from general practitioners. Self-reported questionnaire data were compared with obstetric records for 519 pregnant women participating in the Dutch PRegnancy and Infant DEvelopment (PRIDE) Study from July 2011 through November 2012. These women completed Web-based questionnaires around their first prenatal care visit and in gestational weeks 17 and 34. We calculated kappa statistics (κ) and the observed proportions of positive and negative agreement between the baseline questionnaire and obstetric records for chronic conditions and allergies. In case of inconsistencies between these 2 data sources, medical records from the woman's general practitioner were consulted as the reference standard. For systolic and diastolic blood pressure, intraclass correlation coefficients (ICCs) were calculated for multiple data points. Agreement between the baseline questionnaire and the obstetric record was substantial (κ=.61) for any chronic condition and moderate for any allergy (κ=.51). For specific conditions, we found high observed proportions of negative agreement (range 0.88-1.00) and on average moderate observed proportions of positive agreement with a wide range (range 0.19-0.90). Using the reference standard, the sensitivity of the Web-based questionnaire for chronic conditions and allergies was comparable to or even better than the sensitivity of the obstetric records, in particular for migraine (0.90 vs 0.40, P=.02), asthma (0.86 vs 0.61, P=.04), inhalation allergies (0

The tremendous cost of seeking hospital obstetric care in Bangladesh.

Science.gov (United States)

Afsana, Kaosar

2004-11-01

In Bangladesh, maternal mortality is estimated to be 320 per 100,000 live births, among the highest in the world, and most deliveries in rural areas occur at home. Women with obstetric complications fear to seek hospital care for various reasons; one of which is the tremendous cost. This paper shows how cost impedes rural, poor women's access to emergency obstetric care. The data are from a larger ethnographic study of childbirth practices in 2000--01 in Apurbabari village, the adjacent sub-district health complex and more distant tertiary hospitals at district level. Families had to spend what for them added up to a fortune for a caesarean section and other surgery, medicines, laboratory investigations, blood transfusion, food, travel and other expenses. Corruption in the form of demands for under-the-table payments to obtain these aspects of essential care is rife. Adequate resources should be allocated to the different health facilities, including for emergency obstetric treatment. Thana health complexes (sub-district hospitals) should be upgraded to provide comprehensive obstetric care. The system for prescribing drugs should be reformed and the causes of corruption investigated and addressed. Hospital care should not be allowed to further impoverish the poor. Addressing these issues will help to encourage rural, poor women to seek skilled delivery and post-partum care, particularly in emergency situations.

Assessment of Emergency Obstetric Care Services in Ibadan ...

African Journals Online (AJOL)

AJRH Managing Editor

ORIGINAL RESEARCH ARTICLE ... Nigeria's high maternal mortality has been attributed to poor utilization of obstetric care services to handle ... Poor obstetric outcome in middle and low-income ... Evidence also showed that access to.

Teaching obstetric ultrasound at Mulago Hospital - Kampala, Uganda

African Journals Online (AJOL)

... basic obstetric ultrasound. Keywords: Ultrasound; obstetric; teaching; Uganda; low-resource; curriculum. .... tic and hands-on training were provided by one trainer. (HKA) who at the time .... any formal teaching session. Additionally, the study ...

Economic assessment of Dutch agricultural research

NARCIS (Netherlands)

Poppe, K.J.

2008-01-01

To cope with globalisation and other changes in the industry, in the last 20 years the Dutch Ministry of Agriculture has reorganised its system for education, extension and research considerably. It moved away from the concept of a linear process of innovation to that of an agro-innovation system.

Generating generosity. Financing poor relief through charitable collections in Dutch towns, c. 1600-1800

NARCIS (Netherlands)

Teeuwen, N.M.

2014-01-01

The early modern Dutch welfare system has often been described as relatively generous and efficient. Not only foreigners visiting the Dutch Republic, but also present-day historians have asserted that the Dutch, together with their English neighbours, stood out in early modern Europe in terms of

The Empathy and Systemizing Quotient: The Psychometric Properties of the Dutch Version and a Review of the Cross-Cultural Stability.

Science.gov (United States)

Groen, Y; Fuermaier, A B M; Den Heijer, A E; Tucha, O; Althaus, M

2015-09-01

The 'Empathy Quotient' (EQ) and 'Systemizing Quotient' (SQ) are used worldwide to measure people's empathizing and systemizing cognitive styles. This study investigates the psychometric properties of the Dutch EQ and SQ in healthy participants (n = 685), and high functioning males with autism spectrum disorder (n = 42). Factor analysis provided support for three subscales of the abridged 28-item EQ: Cognitive Empathy, Emotional Empathy and Social Skills. Overall, the Dutch EQ and SQ appeared reliable and valid tools to assess empathizing and systemizing cognitive style in healthy adults and high functioning adults with autism. The literature showed good cross-cultural stability of the SQ and EQ in Western countries, but in Asian countries EQ is less stable and less sensitive to sex differences.

Auditing the standard of anaesthesia care in obstetric units.

Science.gov (United States)

Mörch-Siddall, J; Corbitt, N; Bryson, M R

2001-04-01

We undertook an audit of 15 obstetric units in the north of England over a 10-month period to ascertain to what extent they conformed to the Obstetric Anaesthetists' Association 'Recommended Minimum Standards for Obstetric Anaesthetic Services' using a quality assurance approach. We demonstrated that all units conformed to the majority of standards but did not conform in at least one major and minor area.

Measurement strategies for the Dutch Nuclear Emergency Response System of the National Poisons Control Centre

International Nuclear Information System (INIS)

Van Oostrum, I.E.A.; Joore, J.C.A.; Meulenbelt, J.; Savelkoul, T.J.F.

1997-04-01

The measurement strategy applicable to Public Health in case of a Nuclear Emergency affecting the Netherlands is presented. Within the framework of the Dutch Nuclear Emergency Response System (NPK, abbreviated in Dutch) the National Poisons Control Centre of the RIVM/AZU has an advisory obligation towards the Ministry of Public Health, Welfare and Sports (WVS). This role comprises advice to relevant ministries, coordination of the measurement strategies and advice on persons to be reviewed, i.e. physical, biological and clinical dosimetry. The choice of dosimetric methods and measurements to be achieved in case of a larger scale nuclear emergency in the Netherlands is discussed. An actual plan of handling is presented for this measurement plan. Intervention levels defined in NPK 1991 serve as guidelines for successive actions to be performed by regional health services. 8 figs., 6 tabs., 81 refs

Creating a Dutch testbed to evaluate the retrieval from textual databases

NARCIS (Netherlands)

Hiemstra, Djoerd; van Leeuwen, David A.

This paper describes the first large-scale evaluation of information retrieval systems using Dutch documents and queries. We describe in detail the characteristics of the Dutch test data, which is part of the official CLEF multilingual texttual database, and give an overview of the experimental

Availability and quality of emergency obstetric care in Gambia's main referral hospital: women-users' testimonies

Directory of Open Access Journals (Sweden)

Sundby Johanne

2009-04-01

Full Text Available Abstract Background Reduction of maternal mortality ratio by two-thirds by 2015 is an international development goal with unrestricted access to high quality emergency obstetric care services promoted towards the attainment of that goal. The objective of this qualitative study was to assess the availability and quality of emergency obstetric care services in Gambia's main referral hospital. Methods From weekend admissions a group of 30 women treated for different acute obstetric conditions including five main diagnostic groups: hemorrhage, hypertensive disorders, dystocia, sepsis and anemia were purposively selected. In-depth interviews with the women were carried out at their homes within two weeks of discharge. Results Substantial difficulties in obtaining emergency obstetric care were uncovered. Health system inadequacies including lack of blood for transfusion, shortage of essential medicines especially antihypertensive drugs considerably hindered timely and adequate treatment for obstetric emergencies. Such inadequacies also inflated the treatment costs to between 5 and 18 times more than standard fees. Blood transfusion and hypertensive treatment were associated with the largest costs. Conclusion The deficiencies in the availability of life-saving interventions identified are manifestations of inadequate funding for maternal health services. Substantial increase in funding for maternal health services is therefore warranted towards effective implementation of emergency obstetric care package in The Gambia.

[The emergence of obstetrical mechanism: From Lucy to Homo sapiens].

Science.gov (United States)

Frémondière, P; Thollon, L; Marchal, F

2017-03-01

The evolutionary history of modern birth mechanism is now a renewed interest in obstetrical papers. The purpose of this work is to review the literature in paleo-obstetrical field. Our analysis focuses on paleo-obstetrical hypothesis, from 1960 to the present day, based on the reconstruction of fossil pelvis. Indeed, these pelvic reconstructions usually provide an opportunity to make an obstetrical assumption in our ancestors. In this analysis, we show that modern birth mechanism takes place during the emergence of our genus 2 million years ago. References are made to human specificities related to obstetrical mechanism: exclusive bipedalism, increase of brain size at birth, metabolic cost of the pregnancy and deep trophoblastic implantation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Considerations about our approach to obstetric psychoprophylaxis.

Science.gov (United States)

Cerutti, R; Volpe, B; Sichel, M P; Sandri, M; Sbrignadello, C; Fede, T

1983-01-01

Usually the term "obstetric psychoprophylaxis" refers to a specific method or technique. We prefer to consider it as a procedure that involves on one side the woman, the child and its family, and on the other the services entitled to give pre- and post-natal assistance. In order to realize this, a reformation of our methodological parameters and a critical analysis of the results obtained are required. In the courses of obstetric psychoprophylaxis that are held in the Department of Obstetrics and Gynaecology of the University of Padua we take into consideration the following themes: - Methodological approach - Professional training of the staff - Significance of psychosocial culture in the management of the pregnancy by the health services.

Obstetric risk avoidance: Will anyone be offering obstetrics in private ...

African Journals Online (AJOL)

By the end of the decade indemnifying obstetric risk will probably be too expensive for doctors in private practice. Non-indemnified doctors will be unable or unwilling to do private deliveries; however, women will still fall pregnant and require delivery. These women will inevitably be forced to deliver in provincial facilities, ...

Current obstetrical practice and umbilical cord prolapse.

Science.gov (United States)

Usta, I M; Mercer, B M; Sibai, B M

1999-01-01

The aim of this study was to assess the contribution of current obstetrical practice to the occurrence and complications of umbilical cord prolapse. Maternal and neonatal charts of 87 pregnancies complicated by true umbilical cord prolapse during a 5-year period were reviewed. Twin gestation and noncephalic presentations were common features (14 and 41%, respectively). Eighty-nine percent (77) of infants were delivered by cesarean section of which 29% were classical and 88% were primary. The mean gestational age at delivery was 34.0 +/- 6.0 weeks, and the mean birth weight was 2318 +/- 1159 g. Obstetrical intervention preceded 41 (47%) cases (the obstetrical intervention group): amniotomy (9), scalp electrode application (4), intrauterine pressure catheter insertion (6), attempted external cephalic version (7), expectant management of preterm premature rupture of membranes (14), manual rotation of the fetal head (1), and amnioreduction (1). There were 11 perinatal deaths. Thirty-three percent of the infants (32) had a 5-min Apgar score < 7 and 34% had a cord pH < 7.20. Neonatal seizures, intracerebral hemorrhage, necrotizing enterocolitis, hyaline membrane disease, persistent fetal circulation, sepsis, assisted ventilation, and perinatal mortality were comparable in the "obstetrical intervention" and "no-intervention" groups. Most of the neonatal complications occurred in infants < 32 weeks' gestation. We conclude that obstetrical intervention contributes to 47% of umbilical cord prolapse cases; however, it does not increase the associated perinatal morbidity and mortality.

Perceived antecedents of marital satisfaction among Turkish, Turkish-Dutch, and Dutch couples

NARCIS (Netherlands)

Celenk, O.; van de Vijver, F.J.R.

2013-01-01

We studied mainstream couples in The Netherlands and Turkey as well as Turkish-Dutch immigrant couples to address cultural factors associated with marital satisfaction. A total of 13 Turkish (mainstream couples living in Turkey), 19 Turkish-Dutch (Turkish immigrant couples living in The

The International Network of Obstetric Survey Systems (INOSS): benefits of multi-country studies of severe and uncommon maternal morbidities.

Science.gov (United States)

Knight, Marian

2014-02-01

The International Network of Obstetric Survey Systems (INOSS) is a multi-country collaboration formed to facilitate studies of uncommon and severe complications of pregnancy and childbirth. Collaborations such as INOSS offer many benefits in the study of rare complications. The use of uniform case definitions, common datasets, specifically collected detailed data and prospectively agreed comparative and combined analyses all add to the validity of studies and their utility to guide policy and clinical practice and hence improve the quality of care. Such multi-national collaborations allow for the conduct of robust studies less subject to many of the biases attributed to typical observational studies. For very rare conditions such collaborations may provide the only route to providing high quality evidence to guide practice. Clinicians and researchers conducting studies into rare and severe complications should consider working through a network such as INOSS to maximize the value of their research. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Gender-Marked Determiners Help Dutch Learners' Word Recognition when Gender Information Itself Does Not

Science.gov (United States)

van Heugten, Marieke; Johnson, Elizabeth K.

2011-01-01

Dutch, unlike English, contains two gender-marked forms of the definite article. Does the presence of multiple definite article forms lead Dutch learners to be delayed relative to English learners in the acquisition of their determiner system? Using the Preferential Looking Procedure, we found that Dutch-learning children aged 1 ; 7 to 2 ; 0 use…

21st European Congress of Obstetrics and Gynaecology

DEFF Research Database (Denmark)

Hornnes, Peter

2010-01-01

The 21st European Congress of Obstetrics and Gynaecology took place in Antwerp 5-8 May 2010. The congress provided the participants with an overview of recent scientific and clinical developments throughout the field of obstetrics and gynaecology, and these are summarized in this article....

Students’ Scientific Circle of Obstetrics and Gynaecology

Directory of Open Access Journals (Sweden)

Ivan Polishchuk

2017-06-01

Full Text Available The students’ scientific circle is the kind of teaching obstetrics and gynaecology in a higher medical institution. The circle is an elective form of learning that allows the students to get deeper knowledge of a subject and to perfect themselves in the issues of diagnostics in obstetrics and gynaecology as well as to acquaint themselves with basic medical techniques. It helps identify students who are capable of scientific research and allows the students to improve their ability to analytical perception of professional information, the ability to present it to the audience, ask and answer the questions publicly. The article presents the results of practical and research activities of obstetric and gynaecologic section of the students’ scientific circle of Ivano-Frankivsk National Medical University.

Employment protection in Dutch collective labour agreements

NARCIS (Netherlands)

Schils, T.

2007-01-01

The Dutch system of employment protection is often perceived as too strict for workers on permanent contracts, because of the large procedural inconveniences, difficulty of dismissal and high severance pay. It is suggested that the system of employment protection lowers labour market flexibility by

Determining authority of Dutch case law

NARCIS (Netherlands)

Winkels, R.; de Ruyter, J.; Kroese, H.

2011-01-01

In this paper we present the results of two studies to see whether the analysis of the network of citations between cases can be used as an indication of the relevance and authority in the Dutch legal system. Fowler e.a. have shown such results for the US common law system, but given the different

'Burnout' among Dutch midwives.

NARCIS (Netherlands)

Bakker, R.H.C.; Groenewegen, P.P.; Jabaaij, L.; Meijer, W.; Sixma, H.; Veer, A. de

1996-01-01

OBJECTIVE: to determine the effect of workload on 'burnout' having considered work capacity. DESIGN: cross-sectional study. SETTING: Dutch community midwives in independent practice. PARTICIPANTS: 200 Dutch community midwives. MEASUREMENTS: three-week diary recordings, a questionnaire on practice

Accounts of severe acute obstetric complications in rural Bangladesh.

Science.gov (United States)

Sikder, Shegufta S; Labrique, Alain B; Ullah, Barkat; Ali, Hasmot; Rashid, Mahbubur; Mehra, Sucheta; Jahan, Nusrat; Shamim, Abu A; West, Keith P; Christian, Parul

2011-10-21

As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can be made in maternal health. Though access to medical care is considered to be life-saving during obstetric emergencies, data on the factors associated with health care decision-making during obstetric emergencies are lacking. We aim to describe the health care decision-making process during severe acute obstetric complications among women and their families in rural Bangladesh. Using the pregnancy surveillance infrastructure from a large community trial in northwest rural Bangladesh, we nested a qualitative study to document barriers to timely receipt of medical care for severe obstetric complications. We conducted 40 semi-structured, in-depth interviews with women reporting severe acute obstetric complications and purposively selected for conditions representing the top five most common obstetric complications. The interviews were transcribed and coded to highlight common themes and to develop an overall conceptual model. Women attributed their life-threatening experiences to societal and socioeconomic factors that led to delays in seeking timely medical care by decision makers, usually husbands or other male relatives. Despite the dominance of male relatives and husbands in the decision-making process, women who underwent induced abortions made their own decisions about their health care and relied on female relatives for advice. The study shows that non-certified providers such as village doctors and untrained birth attendants were the first-line providers for women in all categories of severe complications. Coordination of transportation and finances was often arranged through mobile phones, and referrals were likely to be provided by village doctors. Strategies to increase timely and appropriate care seeking for severe obstetric complications may

Accounts of severe acute obstetric complications in Rural Bangladesh

Directory of Open Access Journals (Sweden)

Sikder Shegufta S

2011-10-01

Full Text Available Abstract Background As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can be made in maternal health. Though access to medical care is considered to be life-saving during obstetric emergencies, data on the factors associated with health care decision-making during obstetric emergencies are lacking. We aim to describe the health care decision-making process during severe acute obstetric complications among women and their families in rural Bangladesh. Methods Using the pregnancy surveillance infrastructure from a large community trial in northwest rural Bangladesh, we nested a qualitative study to document barriers to timely receipt of medical care for severe obstetric complications. We conducted 40 semi-structured, in-depth interviews with women reporting severe acute obstetric complications and purposively selected for conditions representing the top five most common obstetric complications. The interviews were transcribed and coded to highlight common themes and to develop an overall conceptual model. Results Women attributed their life-threatening experiences to societal and socioeconomic factors that led to delays in seeking timely medical care by decision makers, usually husbands or other male relatives. Despite the dominance of male relatives and husbands in the decision-making process, women who underwent induced abortions made their own decisions about their health care and relied on female relatives for advice. The study shows that non-certified providers such as village doctors and untrained birth attendants were the first-line providers for women in all categories of severe complications. Coordination of transportation and finances was often arranged through mobile phones, and referrals were likely to be provided by village doctors. Conclusions Strategies to increase timely

Is the role as gatekeeper still feasible? A survey among Dutch general practitioners.

Science.gov (United States)

Wammes, Joost Johan Godert; Jeurissen, Patrick Paulus Theodoor; Verhoef, Lise Maria; Assendelft, Willem J J; Westert, Gert P; Faber, Marjan J

2014-10-01

In the 2012 International Health Policy Survey by the Commonwealth Fund, 57% of Dutch GPs indicated that Dutch patients receive too much health care. This is an unexpected finding, given the clear gatekeeper role of Dutch GPs and recent efforts strengthening this role. The study aims to explore where perceived overuse of care prevails and to identify factors associated with too much care at the entry point of Dutch health care. An American survey exploring perceptions of the amount of care among primary care providers was modified for relevance to the Dutch health system. We further included additional factors possibly related to overuse based on 12 interviews with Dutch GPs. The survey was sent to a random sample of 600 GPs. Dutch GPs (N = 157; response rate 26.2%) indicated that patients receive (much) too much care in general hospitals, primary care, GP cooperatives as well as private clinics. The Dutch responding GPs showed a relatively demand-satisfying attitude, which contributed to the delivery of too much care, often leading to deviation from guidelines and professional norms. The increasing availability of diagnostic facilities was identified as an additional factor contributing to the provision of unnecessary care. Finally, funding gaps between primary care and hospitals impede cooperation and coordination, provoking unnecessary care. Our results--most notably regarding the demand-satisfying attitude of responding GPs--call into question the classical view of the guidance and gatekeeper role of GPs in the Dutch health care system. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dutch elm disease

Science.gov (United States)

James W. Walters

1992-01-01

Since its discovery in the United States in 1930, Dutch elm disease has killed thousands of native elms. The three native elms, American, slippery, and rock, have little or no resistance to Dutch elm disease, but individual trees within each species vary in susceptibility to the disease. The most important of these, American elm, is scattered in upland stands but is...

Measures of reducing obstetric emergencies hysterectomy incidence.

Science.gov (United States)

Ren, Guo-ping; Wang, Bao-lian; Wang, Yan-hong

2016-03-01

To study the obstetric emergency hysterectomy which can reduce the incidence of measures. In maternity of Xinxiang Central Hospital, the total number of deliveries cases has been up to 50,526 in 20 years, of which 48 cases were retrospectively analyzed for the clinical data of Emergency uterine surgery cases. Cases underwent obstetric emergency hysterectomy accounted for 0.095% of total deliveries (48/50 526), in which 11 cases of vaginal delivery, 37 cases of cesarean section. The indications for surgery: 27 cases were cased by placental factors accounted for 56.25%; 14 cases of uterine inertia, accounting for 29.17%; uterine rupture in 4 cases, accounting for 8.33%; 3 cases of coagulopathy, accounting for 6.25%. Where the maternal placental factors hysterectomy is the most common (69.70%, 23/33) and the predominant factor is early maternal uterine inertia (60.00%, 9/15). There are 74.09% (20/27) of patients with placental abnormalities history of previous cesarean section or uterine surgery. The major risk factors leading to obstetric emergency hysterectomy is placental factors. Preventing the occurrence of placental abnormalities planting actively can effectively reduce the rate of obstetric hysterectomy.

The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

Directory of Open Access Journals (Sweden)

Saliku Teresa

2009-03-01

Full Text Available Abstract Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1 delay in making the decision to seek care; 2 delay in reaching an appropriate obstetric facility; and 3 delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden

Obstetrical violence: activism on social networkin

Directory of Open Access Journals (Sweden)

Lia Hecker Luz

2015-12-01

Full Text Available Normal birth in contemporaneity is discussed and the three models of birth care are presented, accordingly to categorization proposed by the north-American anthropologist Davis-Floyd, pointing out the consequences of the technocratic model, which has become hegemonic in contemporary societies, naturalizing obstetrical violence. The problematic is contextualized to Brazilian reality, with the analyses of the blog Cientista que virou mãe making it evident that Brazilian women on social media are articulating themselves in order to defend and give visibility to initiatives of natural and humanized birth, acting against obstetrical violence. It is concluded that Internet tools have allowed a pioneer mobilization in respecting women’s reproductive rights in Brazil, turning blogs into a potential hegemonic alternative way to reach more democratic forms of social organization. In addition to denaturalize the obstetrical violence, the bloggers also act aiming to pave the way for the humanistic approach and to motivate planned home birth initiatives.

The Empathy and Systemizing Quotient : The Psychometric Properties of the Dutch Version and a Review of the Cross-Cultural Stability

NARCIS (Netherlands)

Groen, Y.; Fuermaier, A. B. M.; Den Heijer, A. E.; Tucha, O.; Althaus, M.

The 'Empathy Quotient' (EQ) and 'Systemizing Quotient' (SQ) are used worldwide to measure people's empathizing and systemizing cognitive styles. This study investigates the psychometric properties of the Dutch EQ and SQ in healthy participants (n = 685), and high functioning males with autism

Marxism and the 'Dutch miracle': the Dutch Republic and the transition-debate

NARCIS (Netherlands)

Brandon, P.

2011-01-01

The Dutch Republic holds a marginal position in the debate on the transition from feudalism to capitalism, despite its significance in the early stage of the development of global capitalism. While the positions of those Marxists who did consider the Dutch case range from seeing it as the first

Are you in Control? : That was the key question discussed at the second Dutch Second Dutch Process Control Security Event at the Technical University of Delft, December 4, 2008

NARCIS (Netherlands)

Luiijf, H.A.M.

2009-01-01

The second Dutch Process Control Security Event attracted many process control people. The event was organised by the National Infrastructure against Cybercrime (NICC). Over hundred people responsible for the security of process control systems (PCS) and related networks in many of the Dutch

Partograph utilization and associated factors among obstetric care ...

African Journals Online (AJOL)

Methods: An Institution based cross-sectional study was conducted in June, 2013 on 403 obstetric care providers. A pre-tested and structured ... Being a midwife by profession, on job training, knowledge and attitude of obstetric care providers were factors affecting partograph utilization. Providing on job training for providers ...

Renewable portfolio standard and certificates trading on the Dutch electricity market

International Nuclear Information System (INIS)

Drillsch, J.

2001-01-01

In 1996, the Dutch distribution companies signed a voluntary agreement to reduce CO 2 emissions. As one element of the agreement a renewable portfolio standard (RPS) for the electricity distribution companies with certificates trading was introduced (green label system). The analysis reveals that the total volume of the obligation (3%) can be considered as modest. In addition, it seems more appropriate to replace the distribution companies' current monopoly for the issuing of the certificates by an independent institution. A flexibility mechanism (e.g., a certificates' banking system), which prevents high volatilities in the certificates' market price, and a clear sanction mechanism is needed. A drawback of the current Dutch system is the discriminatory financing of the RPS, which is only provided by MAP tariff customers. Nevertheless, the Dutch RPS may induce an efficient allocation of financial means to support renewable energies. It provides valuable experiences in the functioning of the new system, from which other countries may gain. (author)

Variability of residual fluxes of suspended sediment in a multiple tidal-inlet system : the Dutch Wadden Sea

NARCIS (Netherlands)

Sassi, M.; Duran-Matute, M.; van Kessel, Th.; Gerkema, Th.

2015-01-01

In multiple tidal-inlet systems such as the Dutch Wadden Sea, the exchange of sediments between the coastal lagoon and the adjacent sea is controlled by the combined effect of the tides, wind-driven flows, and density-driven flows. We investigate the variability of residual (tidally averaged) fluxes

Utility of proteomics in obstetric disorders: a review

Directory of Open Access Journals (Sweden)

Hernández-Núñez J

2015-04-01

Full Text Available Jónathan Hernández-Núñez,1 Magel Valdés-Yong21Department of Obstetrics and Gynecology, Hospital Alberto Fernández-Valdés, Santa Cruz del Norte, Mayabeque, 2Department of Obstetrics and Gynecology, Hospital Luis Díaz Soto, Habana del Este, La Habana, CubaAbstract: The study of proteomics could explain many aspects of obstetric disorders. We undertook this review with the aim of assessing the utility of proteomics in the specialty of obstetrics. We searched the electronic databases of MEDLINE, EBSCOhost, BVS Bireme, and SciELO, using various search terms with the assistance of a librarian. We considered cohort studies, case-control studies, case series, and systematic review articles published until October 2014 in the English or Spanish language, and evaluated their quality and the internal validity of the evidence provided. Two reviewers extracted the data independently, then both researchers simultaneously revised the data later, to arrive at a consensus. The search retrieved 1,158 papers, of which 965 were excluded for being duplicates, not relevant, or unrelated studies. A further 86 papers were excluded for being guidelines, protocols, or case reports, along with another 64 that did not contain relevant information, leaving 43 studies for inclusion. Many of these studies showed the utility of proteomic techniques for prediction, pathophysiology, diagnosis, management, monitoring, and prognosis of pre-eclampsia, perinatal infection, premature rupture of membranes, preterm birth, intrauterine growth restriction, and ectopic pregnancy. Proteomic techniques have enormous clinical significance and constitute an invaluable weapon in the management of obstetric disorders that increase maternal and perinatal morbidity and mortality.Keywords: proteomic techniques, obstetrics, diagnosis, prediction

Afrikaans and Dutch as closely-related languages: A comparison to West Germanic languages and Dutch dialects

Directory of Open Access Journals (Sweden)

Wilbert Heeringa

2015-02-01

Full Text Available Following Den Besten’s (2009 desiderata for historical linguistics of Afrikaans, this article aims to contribute some modern evidence to the debate regarding the founding dialects of Afrikaans. From an applied perspective (i.e. human language technology, we aim to determine which West Germanic language(s and/or dialect(s would be best suited for the purposes of recycling speech resources for the benefit of developing speech technologies for Afrikaans. Being recognised as a West Germanic language, Afrikaans is first compared to Standard Dutch, Standard Frisian and Standard German. Pronunciation distances are measured by means of Levenshtein distances. Afrikaans is found to be closest to Standard Dutch. Secondly, Afrikaans is compared to 361 Dutch dialectal varieties in the Netherlands and North-Belgium, using material from the Reeks Nederlandse Dialectatlassen, a series of dialect atlases compiled by Blancquaert and Pée in the period 1925-1982 which cover the Dutch dialect area. Afrikaans is found to be closest to the South-Holland dialectal variety of Zoetermeer; this largely agrees with the findings of Kloeke (1950. No speech resources are available for Zoetermeer, but such resources are available for Standard Dutch. Although the dialect of Zoetermeer is significantly closer to Afrikaans than Standard Dutch is, Standard Dutch speech resources might be a good substitute.

Evaluating the UK and Dutch defined benefit policies using the holistic balance sheet framework

NARCIS (Netherlands)

Chen, Z.; Pelsser, A.; Ponds, E.H.M.

This paper compares the UK and Dutch occupational defined-benefit pension policies using the holistic balance sheet (HBS) framework. The UK DB pension system differs from the Dutch one in terms of the steering tools and adjustment mechanisms. In addition to the sponsor guarantee, the UK system has

Dutch translation and cross-cultural adaptation of the PROMIS® physical function item bank and cognitive pre-test in Dutch arthritis patients.

Science.gov (United States)

Oude Voshaar, Martijn Ah; Ten Klooster, Peter M; Taal, Erik; Krishnan, Eswar; van de Laar, Mart Afj

2012-03-05

Patient-reported physical function is an established outcome domain in clinical studies in rheumatology. To overcome the limitations of the current generation of questionnaires, the Patient-Reported Outcomes Measurement Information System (PROMIS®) project in the USA has developed calibrated item banks for measuring several domains of health status in people with a wide range of chronic diseases. The aim of this study was to translate and cross-culturally adapt the PROMIS physical function item bank to the Dutch language and to pretest it in a sample of patients with arthritis. The items of the PROMIS physical function item bank were translated using rigorous forward-backward protocols and the translated version was subsequently cognitively pretested in a sample of Dutch patients with rheumatoid arthritis. Few issues were encountered in the forward-backward translation. Only 5 of the 124 items to be translated had to be rewritten because of culturally inappropriate content. Subsequent pretesting showed that overall, questions of the Dutch version were understood as they were intended, while only one item required rewriting. Results suggest that the translated version of the PROMIS physical function item bank is semantically and conceptually equivalent to the original. Future work will be directed at creating a Dutch-Flemish final version of the item bank to be used in research with Dutch speaking populations.

Antinuclear antibody testing in obstetric patients | Afman | South ...

African Journals Online (AJOL)

Objectives. To assess possible associations between the presence of antinuclear antibodies (ANAs) and pregnancy outcome in order to determine the significance of this test in obstetric practice. Methods. A case-control study was performed on 408 patients admitted to an obstetric high care unit and on whom ANA testing ...

Abdominal Fascial Closure in Obstetrics: Comparison of Outcome ...

African Journals Online (AJOL)

Background: Midline laparotomies are in common use in obstetrics for caesarean section and other obstetric laparotomies. Current challenges in this surgical approach include the best approach to the repair of the abdominal wall incision, the optimal suture material for its fascial repair and poor cosmetic outcome of the scar ...

Audit of emergency obstetric referrals from a secondary level hospital in Haryana, North India

Directory of Open Access Journals (Sweden)

Shashi Kant

2018-01-01

Full Text Available Background: The maternal mortality ratio in India is high. An effective emergency obstetric care (EmOC strategy has been identified as a priority to reduce maternal deaths. Since the capacity of different levels of public health facilities to provide EmOC is varied, an effective referral system is crucial. However, few studies have evaluated the functioning and quality of referral systems in India. A systematic monitoring of referrals helps to identify current gaps in the provision of essential obstetric care. Objective: This study was conducted to identify the medical and logistic reasons for emergency obstetric referrals from a subdistrict hospital (SDH. Methods: An audit of emergency referrals during the period January 2015–December 2015 was carried out. Records of all obstetric patients referred from the maternity ward during the study period were reviewed. Results: The referral rate was found to be 31.7%. Preterm labor (30.6%, pregnancy-induced hypertension (17%, and fetal distress (10.6% were the main reasons for referral. Deficiencies were found in critical determinants of functionality, that is, nonavailability of emergency cesarean, neonatal care unit, and blood bank. Conclusions: The referral rate at the SDH was high. Lack of workforce and infrastructural facilities led to referrals of women who ought to have been managed at this level of the hospital.

Question Answering for Dutch : Simple does it

NARCIS (Netherlands)

Hoekstra, A.H.; Hiemstra, Djoerd; van der Vet, P.E.; Huibers, Theo W.C.; Schobbens, Pierre-Yves; Vanhoof, Wim; Schwanen, Gabriel

2006-01-01

When people pose questions in natural language to search for information on the web, the role of question answering (QA) systems becomes important. In this paper the QAsystem simpleQA, capable of answering Dutch questions on which the answer is a person or a location, is described. The system's

Obstetrical referrals by traditional birth attendants.

Science.gov (United States)

Mustafa, Rozina; Hashmi, Haleema; Mustafa, Rubina

2012-01-01

In Pakistan 90% of births are conducted by TBA's. In most cases, TBA's are unable to diagnose the complications and are often unable to take decisions on timely referral. The objective of this study was to determine the prevalence, nature and outcome of life threatening obstetrical conditions in referrals by Traditional Birth Attendants (TBAs). This Observational, Descriptive study was conducted from January to December 2007, in the obstetrical unit of Fatima Hospital, Baqai Medical University, a tertiary care community based hospital. The study included patients referred by TBA's who developed life threatening obstetric conditions (LTOCs). Total 64 patients were referred by TBA's. The prevalence was 7.8%. Out of them, 53 (82.8%) patients admitted with life threatening obstetric conditions. The near-miss morbidities and mortalities were 45 (84.9%) and 8 (15%) respectively. Maternal mortality to Near-miss morbidity ratio was 1:6. Obstructed labour caused near-miss morbidity in 32 (60.3%) patients with no mortality. Postpartum haemorrhage as life threatening condition developed in 16 (30.1%) patients with 10 (18.8%) near-miss morbidities and 6 (11.3%) mortalities. Puerperal sepsis accounted for 1 (1.88%) near-miss morbidity and 2 (3.76%) mortalities. The mortality index for puerperal sepsis is (66.6%) almost double of postpartum haemorrhage (37.5%). Mortality to near miss morbidity ratio is high. Misidentification and late referrals of complicated cases by TBA's were responsible for near-miss morbidities and mortalities.

Remembering Dutch-Moluccan radicalism

DEFF Research Database (Denmark)

Marselis, Randi Lorenz

2016-01-01

This article examines memory politics in relation to radical actions of young Dutch-Moluccans, more specifically a train hijacking in 1977 at the village of De Punt in the Netherlands. The article examines how these historical events were remembered in the drama-documentary television film, De Punt...... of the web debate examines how viewers reacted to this interpretation. The web debate functioned as a participatory forum, where collective and national memories and postcolonial history were intensely discussed, and the debate made room for some degree of reconciliation between viewers of Dutch......-Moluccan and of Dutch majority background...

Dutch voices: exploring the role of oral history in Dutch secondary history teaching

NARCIS (Netherlands)

Huijgen, Tim; Holthuis, Paul; Trškan, Danijela

2016-01-01

Oral history may enhance students’ historical content knowledge, historical reasoning competencies, and motivation to learn history. However, little is known regarding the role of oral history in Dutch history education. This study therefore explores the role of oral history in Dutch history

Rural Tanzanian women's awareness of danger signs of obstetric complications

Directory of Open Access Journals (Sweden)

Lindmark Gunilla

2009-03-01

Full Text Available Abstract Background Awareness of the danger signs of obstetric complications is the essential first step in accepting appropriate and timely referral to obstetric and newborn care. The objectives of this study were to assess women's awareness of danger signs of obstetric complications and to identify associated factors in a rural district in Tanzania. Methods A total of 1118 women who had been pregnant in the past two years were interviewed. A list of medically recognized potentially life threatening obstetric signs was obtained from the responses given. Chi- square test was used to determine associations between categorical variables and multivariate logistic regression analysis was used to identify factors associated with awareness of obstetric danger signs. Results More than 98% of the women attended antenatal care at least once. Half of the women knew at least one obstetric danger sign. The percentage of women who knew at least one danger sign during pregnancy was 26%, during delivery 23% and after delivery 40%. Few women knew three or more danger signs. According to multivariate logistic regression analysis having secondary education or more increased the likelihood of awareness of obstetric danger signs six-fold (OR = 5.8; 95% CI: 1.8–19 in comparison with no education at all. The likelihood to have more awareness increased significantly by increasing age of the mother, number of deliveries, number of antenatal visits, whether the delivery took place at a health institution and whether the mother was informed of having a risks/complications during antenatal care. Conclusion Women had low awareness of danger signs of obstetric complications. We recommend the following in order to increase awareness of danger signs of obstetrical complications: to improve quality of counseling and involving other family members in antenatal and postnatal care, to use radio messages and educational sessions targeting the whole community and to intensify

Choosing a health plan: are Dutch consumers loyal to their health insurer?

NARCIS (Netherlands)

Hendriks, M.; Groenewegen, P.P.; Delnoij, D.M.J.

2006-01-01

In 2006, a number of far-reaching reforms have been implemented in the Dutch health insurance system. Giving Dutch consumers the freedom to change health plans every year increases consumer mobility. The idea is that especially consumers who are dissatisfied with their insurer will decide to switch

Self-reported post-discharge symptoms following obstetric neuraxial blockade.

LENUS (Irish Health Repository)

Hayes, N E

2010-10-01

Economic pressures are leading to earlier hospital discharge following delivery, before complications of obstetric neuraxial block may become apparent. Our aim was to estimate the incidence of symptoms presenting post-discharge at a single tertiary obstetric centre.

Determinants of obstetric fistula in Ethiopia. Asrat Atsedeweyn ...

African Journals Online (AJOL)

2017-09-03

Sep 3, 2017 ... factors for obstetrics fistula include early age at pregnan- cy, short stature, illiteracy, poverty, not attending antenatal care, and rural place of residence or living far away from a health facility14. Tesfaye17 used the Cox proportional hazard analysis to evaluate time to recovery of obstetric fistula at Yirgalem.

Biotechnology : A Dutch perspective

NARCIS (Netherlands)

Van Apeldoorn, J.H.F.

1981-01-01

Biotechnology: a Dutch Perspective assesses the future potential of biotechnology in the Netherlands. It has been published in English because it is felt that the Dutch case could be of relevance to other industrialised nations. Although the report is aimed primarily at policy planners and decision

[Obstetrical APS: Is there a place for additional treatment to aspirin-heparin combination?

Science.gov (United States)

Mekinian, A; Kayem, G; Cohen, J; Carbillon, L; Abisror, N; Josselin-Mahr, L; Bornes, M; Fain, O

2017-01-01

Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome. The pregnancy loss despite aspirin and heparin combination define the refractory obstetrical APS, and the prevalence could be estimated to 20-39%. Several other treatments have been used in small and open labeled studies, as steroids, intravenous immunoglobulins, plasma exchanges and hydroxychloroquine to improve the obstetrical outcome. Some other drugs as eculizumab and statins could also have physiopathological rational, but studies are necessary to define the place of these various drugs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

How to Allocate Public Funding to Nongovernmental Development Organizations: A Critical Assessment of the Dutch Co-Financing System

NARCIS (Netherlands)

Ruben, R.; Schulpen, L.W.M.

2009-01-01

The Dutch co-financing system for nongovernmental development organizations (NGDOs) is unique in Europe. Almost a quarter of public development aid is channeled through a selective group of NGDOs that have to satisfy a broad range of institutional and operational criteria. The procedures for

Syntactic Atlas of the Dutch Dialects

NARCIS (Netherlands)

Barbiers, Sjef; Bennis, Hans; Vogelaer, De Gunther; Devos, Magda; Ham, van der Margreet

2005-01-01

Available in a Dutch and English Edition, the Syntactic Atlas of the Dutch Dialects (SAND) provides a detailed overview of the surprisingly rich syntactic variation found in 267 dialects of Dutch at the beginning of the 21th century. 200 full color maps show the geographic distribution of more than

Developing a Service Improvement System for the National Dutch Railways

NARCIS (Netherlands)

Verhoef, Peter C.; Heijnsbroek, Martin; Bosma, Joost

2017-01-01

Customer satisfaction is essential for public and railway services, because firms in these industries have contracts with governments requiring them to achieve specific customer satisfaction targets. In this paper, we describe a National Dutch Railways project in which we identify the major

Causes and consequences of obstetric fistula in Ethiopia: A literature review

Directory of Open Access Journals (Sweden)

Daniel Nigusse Tollosa, Mengistu Asnake Kibret

2013-04-01

Full Text Available ABSTRACTObstetric fistula (OF is one of the major potential complications of childbirth mostly young women in developing countries including Ethiopia. Though few scientific studies have been conducted related to its causes and consequences, it is challenging to find a comprehensive figure about obstetric fistula in Ethiopia. Therefore, this paper sought that to review the causes and consequences of obstetric fistula in Ethiopia. A number of relevant obstetrics and gynaecology websites and journals were reviewed. Google, Pubmed, and Hinari searching engines were used to find out relevant references. Year of publication, location, language and its type of publication were the inclusion criteria used for reviewing literatures. It is observed that obstetric fistula has been a major burdened mainly for women in the rural Ethiopian and its causes and consequences are very deep and diverse. The great majority of obstetric fistula causes in Ethiopia is due to Obstetric labour. Distance to the health care facility, transportation access, economic factors (poverty, poor knowledge related to the problem, poor health seeking behaviour of the affected women and age at first marriage are the other triggering factors. Stigma and discrimination of obstetric fistula patients by their husbands and families, economic dependency and psychological disorder are often mentioned as consequences for OF patients in Ethiopia.

Dutch hi-tech companies exhibit at CERN

CERN Multimedia

Roberto Cantoni

2010-01-01

Twenty-seven Dutch companies will present the state of the art of their technological developments at the industrial exhibition Holland @ CERN from 8 to 11 November. The exhibition is designed to help strengthen the ties between fundamental science and Dutch industry.   The exhibition, supported by the Dutch Ministry of Economic Affairs and organised by the Netherlands National Institute for Subatomic Physics (Nikhef), in cooperation with the Foundation for Fundamental Research on Matter (FOM), the FOM Institute for Plasma Physics Rijnhuizen, and Dutch Scientific, an association of manufacturers of scientific equipment, will be held in the Main Building from 8 to11 November. “The last Holland @ CERN exhibition took place fifteen years ago”, says Robert Klöpping from Nikhef, Dutch Industrial Liaison Officer for CERN and Purchasing Advisor for Grenoble ESRF. “This kind of event is very important for Dutch industry as it allows us to show what Dutch companies c...

Ethical motivation of Dutch egg consumers

NARCIS (Netherlands)

Burrell, A.M.; Vrieze, G.

2003-01-01

This paper analyses a representative sample of 356 Dutch egg consumers in order to measure the extent to which ethical principles concerning the welfare of hens in different rearing systems are translated into egg purchasing intentions, and the extent to which declared intentions are expressed in

Rostering at a Dutch Security Firm

NARCIS (Netherlands)

R. Freling (Richard); N. Piersma (Nanda); A.P.M. Wagelmans (Albert); A. van de Wetering

2001-01-01

textabstractThe roster planning process at the Dutch security firm NVD was traditionally carried out by hand. A few years ago, because of changing labor laws in The Netherlands, this became practically impossible. We developed a decision support system which has four main modules. The first one

Training of midwives in advanced obstetrics in Liberia.

Science.gov (United States)

Dolo, Obed; Clack, Alice; Gibson, Hannah; Lewis, Naomi; Southall, David P

2016-05-01

The shortage of doctors in Liberia limits the provision of comprehensive emergency obstetric and neonatal care. In a pilot project, two midwives were trained in advanced obstetric procedures and in the team approach to the in-hospital provision of advanced maternity care. The training took two years and was led by a Liberian consultant obstetrician with support from international experts. The training took place in CB Dunbar Maternity Hospital. This rural hospital deals with approximately 2000 deliveries annually, many of which present complications. In February 2015 there were just 117 doctors available in Liberia. In the first 18 months of training, the trainees were involved with 236 caesarean sections, 35 manual evacuations of products of conception, 25 manual removals of placentas, 21 vaginal breech deliveries, 14 vacuum deliveries, four repairs of ruptured uteri, the management of four cases of shoulder dystocia, three hysterectomies, two laparotomies for ruptured ectopic pregnancies and numerous obstetric ultrasound examinations. The trainees also managed 41 cases of eclampsia or severe pre-eclampsia, 25 of major postpartum haemorrhage and 21 of shock. Although, initially they only assisted senior doctors, the trainees subsequently progressed from direct to indirect supervision and then to independent management. To compensate for a shortage of doctors able to undertake comprehensive emergency obstetric and neonatal care, experienced midwives can be taught to undertake advanced obstetric care and procedures. Their team work with doctors can be particularly valuable in rural hospitals in resource-poor countries.

Litigation in Obstetrics: a Lesson Learnt and a Lesson to Share

Directory of Open Access Journals (Sweden)

Min Min Chou

2006-03-01

Full Text Available A perfect baby is the expectation of all parents, and a perfect outcome is the mission of obstetrics. Every obstetrician dreads to hear that there is an unexpected maternal mortality and/or severe fetal injury at the hospital. The role of a perceived public expectation of perfection in obstetric medicine reflects a belief that bad outcomes in obstetrics should not be tolerated and that every maternal-fetal injury merits financial compensation and punishment. What has brought these troubling times to obstetric medicine? The drivers behind malpractice crises are the four leading interest groups in the medical-legal debate: pregnant patients and their environment (husband, parents, relatives, friends, legislators, and the media, health-care providers, insurance companies, and trial attorneys. Litigation in obstetrics is the result of a complex of events when malpractice (presumed or real impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medical-legal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with better communication with pregnant women. Communication should be clear, targeted, effective, flexible, and empathic to share a common language and decisions. This review briefly presents and discusses some of the most frequently encountered medical-legal claim cases in obstetric practice. In-depth review of pregnancy-related deaths and major morbidities can help determine strategies needed to continue making pregnancy safer.

Experience and Enlightenment of Dutch Agricultural Research and Technology

NARCIS (Netherlands)

Liu Zhen, Zhen; Hu, D.

2011-01-01

This study analyzes the achievements of agricultural science and technology, the reform of agricultural research system and technology transfer system of agricultural in the Netherlands. With case studies, it tries to find the mode of Dutch agricultural research and technology transfer system, and

Obstetric vesico-vaginal fistula is preventable by timely recognition ...

African Journals Online (AJOL)

Prevention of obstetric fistula should include universal access to maternity care, recognition and timely correction of abnormal progress of labour and punctilious attention to bladder care to avoid post-partum urinary retention. Key words: Obstetric fistula, Risk factors, Pathophysiology, Post-partum urinary retention ...

Ultrasound in obstetric anaesthesia: a review of current applications.

LENUS (Irish Health Repository)

Ecimovic, P

2010-07-01

Ultrasound equipment is increasingly used by non-radiologists to perform interventional techniques and for diagnostic evaluation. Equipment is becoming more portable and durable, with easier user-interface and software enhancement to improve image quality. While obstetric utilisation of ultrasound for fetal assessment has developed over more than 40years, the same technology has not found a widespread role in obstetric anaesthesia. Within the broader specialty of anaesthesia; vascular access, cardiac imaging and regional anaesthesia are the areas in which ultrasound is becoming increasingly established. In addition to ultrasound for neuraxial blocks, these other clinical applications may be of value in obstetric anaesthesia practice.

The Nordic Obstetric Surveillance Study

DEFF Research Database (Denmark)

Colmorn, Lotte B.; Petersen, Kathrine B; Jakobsson, Maija

2015-01-01

by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. MAIN OUTCOME MEASURES: Rates of the studied complications and possible risk factors among parturients in the Nordic countries. RESULTS......OBJECTIVE: To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. DESIGN: Prospective, Nordic collaboration. SETTING: The Nordic Obstetric Surveillance Study...... (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. SAMPLE AND METHODS: Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases...

Communication and Sensemaking in the Dutch Railway System: Explaining coordination failure between teams using a mixed methods approach

NARCIS (Netherlands)

D. Schipper (Danny); L.M. Gerrits (Lasse)

2017-01-01

textabstractEarly in 2014, the Dutch railway system spiralled out of control after traffic management was confronted with the decision to take four double switches and two rail tracks out of service. A lack of coordination between the responsible teams resulted in the decision to stop all traffic in

Blood transfusion in obstetrics: attitude and perceptions of pregnant ...

African Journals Online (AJOL)

Background: Obstetrics haemorrhage is the leading cause of preventable maternal deaths worldwide. Blood transfusion is pivotal to death reduction, but are the women aware of its importance? Objectives: The study investigated the view of a population of pregnant women on obstetrics related blood transfusion. Methods: ...

Communication in obstetrics: where and when it matters | Obimbo ...

African Journals Online (AJOL)

Although most clinical outcomes in obstetrics are generally good, poor and inaccurate communication may lead to unwanted obstetrics complications and medico-legal litigation. Effective communication therefore, is an important and integral part of holistic approach to good patient care and management. We present a case ...

Views of senior health personnel about quality of emergency obstetric care: A qualitative study in Nigeria.

Science.gov (United States)

Okonofua, Friday; Randawa, Abdullahi; Ogu, Rosemary; Agholor, Kingsley; Okike, Ola; Abdus-Salam, Rukayat Adeola; Gana, Mohammed; Abe, Eghe; Durodola, Adetoye; Galadanci, Hadiza

2017-01-01

Late arrival in hospital by women experiencing pregnancy complications is an important background factor leading to maternal mortality in Nigeria. The use of effective and timely emergency obstetric care determines whether women survive or die, or become near-miss cases. Healthcare managers have the responsibility to deploy resources for implementing emergency obstetric care. To determine the nature of institutional policies and frameworks for managing obstetric complications and reducing maternal deaths in Nigeria. Thirty-six hospital managers, heads of obstetrics department and senior midwives were interviewed about hospital infrastructure, resources, policies and processes relating to emergency obstetric care, whilst allowing informants to discuss their thoughts and feelings. The interviews were audiotaped, transcribed and analyzed using Atlas ti 6.2software. Hospital managers are aware of the seriousness of maternal mortality and the steps to improve maternal healthcare. Many reported the lack of policies and specific action-plans for maternal mortality prevention, and many did not purposely disburse budgets or resources to address the problem. Although some reported that maternal/perinatal audit take place in their hospitals, there was no substantive evidence and no records of maternal/perinatal audits were made available. Respondents decried the lack of appropriate data collection system in the hospitals for accurate monitoring of maternal mortality and identification of appropriate remediating actions. Healthcare managers are handicapped to properly manage the healthcare system for maternal mortality prevention. Relevant training of healthcare managers would be crucial to enable the development of strategic implementation plans for the prevention of maternal mortality.

Technical dependability of obstetric ultrasound transmission via ISDN.

Science.gov (United States)

Nores, J; Athanassiou, A; Malone, F D; D'Alton, M E

1997-01-01

To evaluate the dependability of a live telemedicine link for the transmission of obstetric ultrasonograms using a commercial telephone network. We established an integrated services digital network (ISDN), consisting of three dedicated telephone lines from three satellite offices, to our central prenatal diagnostic center. All patients had a sonographic evaluation recorded on videotape by a trained sonographer. A live interactive video telemedicine link was then established, and a perinatologist directed the sonographer through the scan. A report was issued on the basis of the telemedicine examination. The number of calls required to obtain satisfactory real-time images was recorded, as were the reasons for suboptimal transmissions. The first 150 transmissions were excluded from this study. The results in the subsequent 100 patients who agreed to participate were analyzed. We were able to provide obstetric interpretations in all 100 patients scheduled to be examined using the telemedicine link. A single connection was required in 85 cases, two calls in 5 cases, three calls in 8 cases, four calls in 1 case, and five calls in another case. A repeat call was required in 20 cases because of poor image transmission; other repeat calls were caused by failure to connect (5 cases), calls disconnected (2 cases), and no image transmission (2 cases). The provision of telemedicine services for obstetric ultrasonography in the community is feasible, but the need for repeat connections because of technical failures needs to be incorporated into cost and time analyses in order to provide a measure of the system's efficiency.

The New Dutch 'Base Exemption Regime' and the Spirit of the Internal Market

NARCIS (Netherlands)

de Wilde, M.F.; Wisman, C.

2013-01-01

As of 1 January 2012, the Dutch corporate income tax (CIT) system provides for international juridical double tax relief (DTR) under a mechanism referred to in Dutch tax practice as the ‘base exemption for foreign business profits’ (author’s translation). The newly introduced DTR mechanism replaces

Parent involvement as professionalization: professionals' struggle for power in Dutch urban deprived areas

NARCIS (Netherlands)

van den Berg, M.; van Reekum, R.

2011-01-01

Parent involvement policies have been central in the Dutch push towards educational governance. How the implementation of these policies plays out on the ground is context‐dependent. The ethnic and class cleavages impacting the Dutch educational system should be taken into account. On the basis of

The Dutch nuclear programme

International Nuclear Information System (INIS)

1986-01-01

Engineering Services Ltd. has, in fulfillment of its contractual commitment to the Dutch Industrial Council for Energy and Environment Technology (IREM), investigated the broad capability of the Dutch industry in playing a major role in the supply of goods and services for the construction of nuclear plants in the Netherlands. The findings are summarized in this document. 5 tabs

Performance of Dutch children on the Bayley III: a comparison study of US and Dutch norms.

Science.gov (United States)

Steenis, Leonie J P; Verhoeven, Marjolein; Hessen, Dave J; van Baar, Anneloes L

2015-01-01

The Bayley Scales of Infant and Toddler Development-third edition (Bayley-III) are frequently used to assess early child development worldwide. However, the original standardization only included US children, and it is still unclear whether or not these norms are adequate for use in other populations. Recently, norms for the Dutch version of the Bayley-III (The Bayley-III-NL) were made. Scores based on Dutch and US norms were compared to study the need for population-specific norms. Scaled scores based on Dutch and US norms were compared for 1912 children between 14 days and 42 months 14 days. Next, the proportions of children scoring Dutch norms fluctuated around values based on US norms on all subtests. The extent of the deviations differed across ages and subtests. Differences in means were significant across all five subtests (p Dutch norms resulted in over-referral regarding gross motor skills, and under-referral regarding cognitive, receptive communication, expressive communication, and fine motor skills. The Dutch norms differ from the US norms for all subtests and these differences are clinically relevant. Population specific norms are needed to identify children with low scores for referral and intervention, and to facilitate international comparisons of population data.

A qualitative study of the experience of obstetric fistula survivors in Addis Ababa, Ethiopia

Directory of Open Access Journals (Sweden)

Gebresilase YT

2014-12-01

Full Text Available Yenenesh Tadesse Gebresilase Programme Quality Department, Vita, Addis Ababa, Ethiopia Abstract: Research on obstetric fistula has paid limited attention to the lived experiences of survivors. This qualitative study explored the evolution of survivors' perceptions of their social relationships and health since developing this obstetric complication. In-depth interviews were conducted with eight survivors who were selected based on purposive and snowball sampling techniques. Thematic categorization and content analysis was used to analyze the data. The resultant themes included participants' understanding of factors predisposing to fistula, challenges they encounter, their coping responses, and the meaning of their experiences. First, the participants had a common understanding of the factors that predisposed them to obstetric fistula. They mentioned poor knowledge about pregnancy, early marriage, cultural practices, and a delay in or lack of access to emergency obstetric care. Second, the participants suffered from powerlessness experienced during their childhood and married lives. They also faced prolonged obstructed labor, physical injury, emotional breakdown, depression, erosion of social capital, and loss of healthy years. Third, to control their negative emotions, participants reported isolating themselves, having suicidal thoughts, positive interpretation about the future, and avoidance. To obtain relief from their disease, the women used their family support, sold their properties, and oriented to reality. Fourth, the participants were struggling to keep going, to accept their changed reality, and to change their perspectives on life. In conclusion, obstetric fistula has significant physical, psychosocial, and emotional consequences. The study participants were not passive victims but rather active survivors of these challenges. Adequate support was not provided by their formal or informal support systems. To prevent and manage obstetric

[Centralization in obstetrics: pros and cons].

Science.gov (United States)

Roemer, V M; Ramb, S

1996-01-01

Possible advantages and disadvantages of a general centralization of German obstetric facilities are analysed in the study. The need for centralization of risk cases, especially premature births (regionalization) is pointed out. Centralization appears appropriate, since every fifth maternity unit in Germany (19.78%) has 300 or fewer deliveries per year. This one fifth of perinatal clinics accounts for 6.3% of all deliveries (N = 49450). There are appreciable differences between the old and new federal states (Bundesländer): in the recently acceded federal states, 48.7% of all perinatal clinics have deliveries of 300 and less per year. This group of perinatal clinics accounts for 29% of all deliveries in the new federal states. We have carried out a survey of the mother's attitude to centralization: out of 416 patients in the Detmold women's hospital whose mean age was 29.0 +/- 4.2 years, 90.4% were not in favor of general centralization of obstetrics. 43% were also against a centralization of risk cases (regionalization). 75% of the women surveyed objected to centralized obstetrics because of the 'possible absence of the family', the 'possible absence of students and trainees' (44.9%), the 'unfamiliarity with staff and premises' (41.8%) and 'fear of anonymity' (44.5%). The majority of all women (84.1%) did not want to have a drive more than 20 km to an obstetrics center. Fear of 'delivery in a taxi'(78.6%), the 'fear that the husband will come too late to the delivery' (65.4%) and that the 'overall course of the delivery might not be adequate for reasons of time'. The presence of a pediatrics department in conjunction with the perinatal clinic was rated very positively (93%). It is concluded from the data and further juridical considerations that centralization of risk cases (regionalization) is indispensable in the near future and that somewhat more further into the future decentralization should be carried out by closing obstetrics departments with substantially

Estimating the risk of dengue transmission from Dutch blood donors travelling to Suriname and the Dutch Caribbean.

Science.gov (United States)

Oei, W; Lieshout-Krikke, R W; Kretzschmar, M E; Zaaijer, H L; Coutinho, R A; Eersel, M; Jubithana, B; Halabi, Y; Gerstenbluth, I; Maduro, E; Tromp, M; Janssen, M P

2016-05-01

The risk of dengue transmitted by travellers is known. Methods to estimate the transmission by transfusion (TT) risk from blood donors travelling to risk areas are available, for instance, the European Up-Front Risk Assessment Tool (EUFRAT). This study aimed to validate the estimated risk from travelling donors obtained from EUFRAT. Surveillance data on notified dengue cases in Suriname and the Dutch Caribbean islands (Aruba, Curaçao, St. Maarten, Bonaire, St. Eustatius and Saba) in 2001-2011 was used to calculate local incidence rates. Information on travel and donation behaviour of Dutch donors was collected. With the EUFRAT model, the TT risks from Dutch travelling donors were calculated. Model estimates were compared with the number of infections in Dutch travellers found by laboratory tests in the Netherlands. The expected cumulative number of donors becoming infected during travels to Suriname and the Dutch Caribbean from 2001 to 2011 was estimated at 5 (95% CI, 2-11) and 86 (45-179), respectively. The infection risk inferred from the laboratory-based study was 19 (9-61) and 28 (14-92). Given the independence of the data sources, these estimates are remarkably close. The model estimated that 0·02 (0·001-0·06) and 0·40 (0·01-1·4) recipients would have been infected by these travelling donors. The EUFRAT model provided an estimate close to actual observed number of dengue infections. The dengue TT risk among Dutch travelling donors can be estimated using basic transmission, travel and donation information. The TT risk from Dutch donors travelling to Suriname and the Dutch Caribbean is small. © 2016 International Society of Blood Transfusion.

Maternal morbid obesity and obstetric outcomes.

LENUS (Irish Health Repository)

Farah, Nadine

2012-02-01

OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

Obstetric complications and asthma in childhood.

Science.gov (United States)

Xu, B; Pekkanen, J; Järvelin, M R

2000-01-01

Studies have shown that perinatal factors are associated with childhood asthma. The current analyses examined the association between obstetric complications and risk of asthma at the age of 7 years using a prospectively population-based birth cohort in northern Finland. Results indicated that obstetric complications were associated with a higher risk of asthma among children. Those children who were administered special procedures at birth, i.e., cesarean section, vacuum extraction, and other procedures, including use of forceps, manual auxiliary, and extraction breech, had an adjusted odds ratio (OR) for asthma of 1.38 (95% confidence interval [CI] 1.00-1.92), 1.32 (95% CI 0.80-2.19), and 2.14 (95% CI 1.06-4.33), respectively, as compared to children who were delivered normally. Children who had a lower Apgar score at the first and the fifth minute after birth also had a higher risk as compared to those who had an Apgar score of 9-10. The results encourage further evaluation of the association between obstetric complications and risk of asthma among children in other populations, and further exploration of possible mechanisms underlying the association.

Time-to-recovery from obstetric fistula and associated factors: The ...

African Journals Online (AJOL)

EPHA USER33

potential risk factors associated with time to recovery of patients from obstetric fistula. Methods: An ... maternal health service and emergency obstetric care are contributing ..... process that causes the fistula may also lead to further destruction ...

Surgical Site Infection Rate and Risk Factors among Obstetric Cases ...

African Journals Online (AJOL)

2009-04-01

Among surgical patients in obstetrics, Surgical Site Infections were the most ... for delivery from April 1, 2009 to March 31, 2010 in obstetric ward of the Hospital. ... applying improved surgical techniques and improving infection prevention ...

Placental vascular pathology and increased thrombin generation as mechanisms of disease in obstetrical syndromes

Directory of Open Access Journals (Sweden)

Salvatore Andrea Mastrolia

2014-11-01

Full Text Available Obstetrical complications including preeclampsia, fetal growth restriction, preterm labor, preterm prelabor rupture of membranes and fetal demise are all the clinical endpoint of several underlying mechanisms (i.e., infection, inflammation, thrombosis, endocrine disorder, immunologic rejection, genetic, and environmental, therefore, they may be regarded as syndromes. Placental vascular pathology and increased thrombin generation were reported in all of these obstetrical syndromes. Moreover, elevated concentrations of thrombin-anti thrombin III complexes and changes in the coagulation as well as anticoagulation factors can be detected in the maternal circulation prior to the clinical development of the disease in some of these syndromes. In this review, we will assess the changes in the hemostatic system during normal and complicated pregnancy in maternal blood, maternal–fetal interface and amniotic fluid, and describe the contribution of thrombosis and vascular pathology to the development of the great obstetrical syndromes.

Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

Science.gov (United States)

Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

2018-03-15

Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service

Sustainable Entrepreneurship in the Dutch Construction Industry

Directory of Open Access Journals (Sweden)

Rosalinde J.A. Klein Woolthuis

2010-02-01

Full Text Available This article discusses the strategies that sustainable entrepreneurs use to interact with their environment in the Dutch construction industry. The Dutch construction industry is under great pressure to move towards sustainability, and entrepreneurs are believed to be able to play a large role in this transition by introducing new products and new business practices. But how can entrepreneurs prosper in an environment that is not geared up towards such a change? And which strategies do they use to bend conditions in their favor? In this article we make use of the Market and System Failure Framework to analyze the pressures that entrepreneurs are confronted with when introducing sustainable innovations. We recognize that these pressures can be seen as bottlenecks, but that market and system failures can also create entrepreneurial opportunities. We interviewed 16 entrepreneurs in the Dutch construction industry to determine the influences they experienced from their environment and the strategies they use to deal with these. We conclude that we can distinguish between system building and following entrepreneurs, where the former aims to build a new system to challenge the old one, whereas the latter rather makes use of existing structures to build a business. We find that both strategies can be successful and that overall, the entrepreneurs confirm the belief that sustainability on people, planet and transparency aspects, can contribute very well to the long term profitability of the businesses the entrepreneurs are running. These in-depth insights into the influences from the context on the one hand, and the entrepreneurs’ strategic reactions on the other hand, contribute to our understanding of the interactions between entrepreneurs and the system context. This can help us to more effectively stimulate and support innovating entrepreneurs to contribute to the transition towards sustainability.

Ethnic density is not associated with psychological distress in Turkish-Dutch, Moroccan-Dutch and Surinamese-Dutch ethnic minorities in the Netherlands.

Science.gov (United States)

Schrier, Agnes C; Peen, Jaap; de Wit, Matty A S; van Ameijden, Erik J C; Erdem, Ozcan; Verhoeff, Arnoud P; Dekker, Jack J M; Beekman, Aartjan T F

2014-10-01

Ethnic density, the proportion of people of the same ethnic group in the neighbourhood, has been identified as a protective factor with regard to mental health in ethnic minorities. Research on the putative intermediating factors, exposure to discrimination and improved social support, has not yielded conclusive evidence. We investigated the association between ethnic density and psychological well-being in three ethnic minority groups in the Netherlands. We also assessed whether a protective ethnic density effect is related to the degree to which each group experiences discrimination and social support at group level. Using multi-level linear regression modelling, we studied the influence of ethnic density at neighbourhood level on psychological distress, measured with the Kessler Psychological Distress scale (K10), in 13,864 native Dutch, 1,206 Surinamese-Dutch, 978 Turkish-Dutch and 784 Moroccan-Dutch citizens of the four major cities in the Netherlands. Based on a nationwide survey among ethnic minorities on social integration, ethnic groups were ordered with respect to the intermediating factors. Ethnic density was not associated with psychological distress in any of the three ethnic minority groups. As a consequence, we found no support for either experiences of discrimination or for own-group social interactions at group level as intermediating factors. In all three ethnic minority groups, as well as in the native Dutch group, individual demographic and socio-economic factors emerged as the main explanations for individuals' mental well-being. These results suggest that individual demographic and socio-economic risk characteristics outweigh the influence of neighbourhood attributes on mental health.

Strategies to reduce blood product utilization in obstetric practice.

Science.gov (United States)

Neb, Holger; Zacharowski, Kai; Meybohm, Patrick

2017-06-01

Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine. Intravenous iron can be considered a safe, effective strategy to replenish iron stores and to correct both pregnancy-related and hemorrhage-related iron deficiency anemia. In addition to surgical techniques and the use of uterotonics, recent findings support early administration of tranexamic acid, fibrinogen and a coagulation factor concentrate-based, viscoelastically guided practice in case of peripartum hemorrhage to manage coagulopathy. In patients with cesarean section, autologous red cell blood salvage may reduce blood product utilization, although its use in this setting is controversial. Implementation of PBM in obstetric practice offers large potential to reduce blood loss and transfusion requirements of allogeneic blood products, even though large clinical trials are lacking in this specific field. Intravenous iron supplementation may be suggested to increase peripartum hemoglobin levels. Additionally, tranexamic acid and point-of-care-guided supplementation of coagulation factors are potent methods to reduce unnecessary blood loss and blood transfusions in obstetrics.

PROVISION OF THE DUTY SERVICE IN GYNECOLOGY AND OBSTETRICS IN SLOVENIA

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Iztok Takač

2018-02-01

Full Text Available Background: Duty service of gyecology and obstetrics in Slovenia is organized on the regional basis and consists of ten regional hospitals, two hospitals for gynecology and obstetrics and two university clinical centres. Methods: Heads of hospitals where duty service is performed, have answered the questionnaires about the doctors who perform duty service. Results: Specialists and trainees in gynecology and obstetrics perform duty service on 21 posts and on 6 on-call posts. In Slovenia there are 287 active specialists in gynecology and obstetrics. 139 (48.4% among them are active on the primary level (outpatient clinics and 148 (51.6% in the hospitals and both clinical centres. Among hospital gynecologists and obstetricians 54 (36.5% of them are older than 55 years. Conclusions: Duty service of gyecology and obstetrics in Slovenia does not meet legislation criteria regard- ing doctors’ work time. Adequate changes for increasing the number of available doctors for duty service are proposed.

Income smoothing by Dutch hospitals

NARCIS (Netherlands)

Boterenbrood, D.R.

2014-01-01

Research indicates that hospitals manage their earnings. However, these findings might be influenced by methodological issues. In this study, I exploit specific features of Dutch hospitals to study income smoothing while limiting these methodological issues. The managers of Dutch hospitals have the

Lesjes van de Nederlanders: Little Lessons from the Dutch to Promote Educational Quality.

Science.gov (United States)

Palmer, Barbara H.

1996-01-01

A study explored quality assessment and accountability in Dutch university education. The national system of quality assurance and various models used successfully to implement it are described, and the range of apparent effects and influences of quality assurance on Dutch higher education are examined. Comparison is made with American higher…

Ultrasonogram in obstetric field

International Nuclear Information System (INIS)

Joo, K. B.; Song, C. H.; Lee, H. B.

1980-01-01

The clinical evaluation of 535 cases of sonogram from Mar. 1, 1979 to Oct. 30, 1979 in obstetric field at Department of Radiology and Ob. and Gy. Eul-Ji General Hospital. We present these cases: normal pregnancy, missed abortion, twin pregnancy, hydatidiform mole and ectopic pregnancy, with brief review of literature.

Reflections of Civil and Criminal Liability in Obstetrical Violence Cases

Directory of Open Access Journals (Sweden)

Roberto Carvalho Veloso

2016-10-01

Full Text Available Obstetric violence is characterized by the imposition of interventions harmful to the physical and psychological integrity of pregnant women, perpetrated by health professionals and institutions (public and private in which such women are assisted. This paper aims to discuss the civil and criminal liability in cases of obstetric violence, from the judgments of the Supreme Court (STF, Superior Court of Justice (STJ and the Courts of Justice (TJs of the Rio Grande do Sul State and Minas Gerais, in order to identify the nature of the punishment and characterization of obstetric violence.

Participation determinants in the DRG payment system of obstetrics and gynecology clinics in South Korea.

Science.gov (United States)

Song, Jung-Kook; Kim, Chang-yup

2010-03-01

The Diagnosis Related Group (DRG) payment system, which has been implemented in Korea since 1997, is based on voluntary participation. Hence, the positive impact of this system depends on the participation of physicians. This study examined the factors determining participation of Korean obstetrics & gynecology (OBGYN) clinics in the DRG-based payment system. The demographic information, practice-related variables of OBGYN clinics and participation information in the DRG-based payment system were acquired from the nationwide data from 2002 to 2007 produced by the National Health Insurance Corporation and the Health Insurance Review & Assessment Service. The subjects were 336 OBGYN clinics consisting of 43 DRG clinics that had maintained their participation in 2003-2007 and 293 no-DRG (fee-for-service) clinics that had never been a DRG clinic during the same period. Logistic regression analysis was carried out to determine the factors associated with the participation of OBGYN clinics in the DRG-based payment system. The factors affecting participation of OBGYN clinics in the DRG-based payment system were as follows (psystem are more likely to participate in the DRG-based payment system. Therefore, to ensure adequate participation of physicians, a payment system with a stronger financial incentive might be more suitable in Korea.

Study on profits and the financial position of the Dutch power transmission system operator Tennet 2005-2009

International Nuclear Information System (INIS)

2010-12-01

A study has been conducted into the profits of the grid operator of the Dutch national high-voltage power transmission system operator TenneT in the years 2005 to 2009. Also attention is paid to the financial position of TenneT. These results are taken into account with regard to method decisions for TenneT in the fifth regulatory period. [nl

Dutch Corporate Finance, 1602-1850

NARCIS (Netherlands)

A. de Jong (Abe); J. Jonker (Joost); A. Roëll (Ailsa)

2013-01-01

textabstractEarly Modern Dutch corporate finance had two notable features, a remarkable ease of raising large amounts of capital and a flexible legal framework. Having pioneered new corporate forms with two intercontinental trading companies, Dutch business adopted such forms on a wider scale only

Assessment of the Dutch organ-culture system of corneal preservation within the Eye Bank of South Australia.

Science.gov (United States)

Williams, K A; Noack, L M; Alfrich, S J; Danz, R; Erickson, S A; Coster, D J

1988-02-01

Thirteen per cent of all corneas harvested by the Eye Bank of South Australia during 1986 were discarded because storage time in McCarey-Kaufman medium exceeded four days. We have therefore examined the suitability of the Dutch method of long-term corneal storage for our purposes. Twenty-two human corneas that had been discarded from the Eye Bank were assessed using the trypan blue-sucrose staining technique, and then placed into long-term storage for 15 to 17 days. They were then reassessed by vital dye staining before permanent flat-mounts were prepared for silver staining of the endothelium. A good correlation (albeit subjective) was found between the non-destructive and destructive techniques of endothelial cell assessment. Those corneas that failed to survive organ culture storage were easily detected. The Dutch system of corneal preservation and post-storage assessment seems well-suited to Australian eye-banking.

Teaching Guatemalan traditional birth attendants about obstetrical emergencies.

Science.gov (United States)

Garcia, Kimberly; Dowling, Donna; Mettler, Gretchen

2018-06-01

Guatemala's Maternal Mortality Rate is 65th highest in the world at 120 deaths per 100,000 births. Contributing to the problem is traditional birth attendants (TBAs) attend most births yet lack knowledge about obstetrical emergencies. Government trainings in existence since 1955 have not changed TBA knowledge. Government trainings are culturally insensitive because they are taught in Spanish with written material, even though most TBAs are illiterate and speak Mayan dialects. The purpose of the observational study was to evaluate the effect of an oral training, that was designed to be culturally sensitive in TBAs' native language, on TBAs' knowledge of obstetrical emergencies. one hundred ninety-one TBAs participated. The study employed a pretest-posttest design. A checklist was used to compare TBAs' knowledge of obstetrical emergencies before and after the training. the mean pretest score was 5.006±SD 0.291 compared to the mean posttest score of 8.549±SD 0.201. Change in knowledge was a P value of 0.00. results suggest an oral training that was designed to be culturally sensitive in the native language improved TBAs' knowledge of obstetrical emergencies. Future trainings should follow a similar format to meet the needs of illiterate audiences in remote settings. Copyright © 2018 Elsevier Ltd. All rights reserved.

Hypothermia and acute alcohol intoxication in Dutch adolescents : The relationship between core and outdoor temperatures

NARCIS (Netherlands)

Schreurs, Claire J.; Van Hoof, Joris J.; van der Lely, Nico

2017-01-01

Purpose: To investigate hypothermia and its potential association with core and outdoor temperatures in adolescents suffering from acute alcohol intoxication. Methods: Data were derived from the Dutch Pediatric Surveillance System, which monitors alcohol intoxication among all Dutch adolescents.

Access barriers to obstetric care at health facilities in sub-Saharan Africa-a systematic review.

Science.gov (United States)

Kyei-Nimakoh, Minerva; Carolan-Olah, Mary; McCann, Terence V

2017-06-06

facilities, poor staff knowledge and skills, poor referral practices and poor staff interpersonal relationships. Despite similarities in obstetric care barriers across sub-Saharan Africa, country-specific strategies are required to tackle the challenges mentioned. Governments need to develop strategies to improve healthcare systems and overall socioeconomic status of women, in order to tackle supply- and demand-side access barriers to obstetric care. It is also important that strategies adopted are supported by research evidence appropriate for local conditions. Finally, more research is needed, particularly, with regard to supply-side interventions that may improve the obstetric care experience of pregnant women. PROSPERO 2014 CRD42014015549.

Vaginal versus Obstetric Infection Escherichia coli Isolates among Pregnant Women: Antimicrobial Resistance and Genetic Virulence Profile.

Directory of Open Access Journals (Sweden)

Emma Sáez-López

Full Text Available Vaginal Escherichia coli colonization is related to obstetric infections and the consequent development of infections in newborns. Ampicillin resistance among E. coli strains is increasing, which is the main choice for treating empirically many obstetric and neonatal infections. Vaginal E. coli strains are very similar to extraintestinal pathogenic E. coli with regards to the virulence factors and the belonging to phylogroup B2. We studied the antimicrobial resistance and the genetic virulence profile of 82 E. coli isolates from 638 vaginal samples and 63 isolated from endometrial aspirate, placental and amniotic fluid samples from pregnant women with obstetric infections. The prevalence of E. coli in the vaginal samples was 13%, which was significant among women with associated risk factors during pregnancy, especially premature preterm rupture of membranes (p<0.0001. Sixty-five percent of the strains were ampicillin-resistant. The E. coli isolates causing obstetric infections showed higher resistance levels than vaginal isolates, particularly for gentamicin (p = 0.001. The most prevalent virulence factor genes were those related to the iron uptake systems revealing clear targets for interventions. More than 50% of the isolates belonged to the virulent B2 group possessing the highest number of virulence factor genes. The ampicillin-resistant isolates had high number of virulence factors primarily related to pathogenicity islands, and the remarkable gentamicin resistance in E. coli isolates from women presenting obstetric infections, the choice of the most appropriate empiric treatment and clinical management of pregnant women and neonates should be carefully made. Taking into account host-susceptibility, the heterogeneity of E. coli due to evolution over time and the geographical area, characterization of E. coli isolates colonizing the vagina and causing obstetric infections in different regions may help to develop interventions and avoid the

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version.

Science.gov (United States)

Vlemmix, Floortje; Rosman, Ageeth N; Fleuren, Margot A H; Rijnders, Marlies E B; Beuckens, Antje; Haak, Monique C; Akerboom, Bettina M C; Bais, Joke M J; Kuppens, Simone M I; Papatsonis, Dimitri N; Opmeer, Brent C; van der Post, Joris A M; Mol, Ben Willem J; Kok, Marjolein

2010-05-10

Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less.We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV.The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Dutch Trial Register (NTR): 1878.

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

Directory of Open Access Journals (Sweden)

Papatsonis Dimitri N

2010-05-01

Full Text Available Abstract Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV and the Dutch Society for Obstetrics and Gynaecology (NVOG. Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial

The role of women on Dutch farms

OpenAIRE

Meulen, van der, H.A.B.; Terluin, I.J.; Matser, I.A.

2015-01-01

In this paper an analysis is made of the contribution of women to labour input and management on Dutch farms. We used a written survey among the participants of the Dutch Farm Accountancy Data Network (FADN), in-depth interviews and a group discussion with farm women. Over half of the women on Dutch farms spend more than ten hours per week on agricultural activitieson the farm. More than 40% of women on Dutch farms have paid work off farm. The majority of the respondents’ farms is legally org...

The Dutch surgical colorectal audit

NARCIS (Netherlands)

van Leersum, N. J.; Snijders, H. S.; Henneman, D.; Kolfschoten, N. E.; Gooiker, G. A.; ten Berge, M. G.; Eddes, E. H.; Wouters, M. W. J. M.; Tollenaar, R. A. E. M.; Bemelman, W. A.; van Dam, R. M.; Elferink, M. A.; Karsten, Th M.; van Krieken, J. H. J. M.; Lemmens, V. E. P. P.; Rutten, H. J. T.; Manusama, E. R.; van de Velde, C. J. H.; Meijerink, W. J. H. J.; Wiggers, Th; van der Harst, E.; Dekker, J. W. T.; Boerma, D.

2013-01-01

In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated by the Dutch

Acute Respiratory Distress Syndrome in Obstetric Patients

Directory of Open Access Journals (Sweden)

S. V. Galushka

2007-01-01

Full Text Available Objective: to define the specific features of the course of acute respiratory distress syndrome (ARDS in puer-peras with a complicated postpartum period. Subjects and methods. Sixty-seven puerperas with ARDS were examined. Group 1 included 27 puerperas with postpartum ARDS; Group 2 comprised 10 puerperas who had been treated in an intensive care and died; Group 3 consisted of nonobstetric patients with ARDS of various genesis (a control group. Results. In obstetric patients, the baseline oxygenation index was significantly lower than that in the control group. However, Group 1 patients showed a rapid increase in PaO2/FiO2 on days 3—4 of treatment. In the control group, the changes occurred later — on days 5—6. The baseline alveolar-arterial oxygen difference was significantly higher in the obstetric patients than that in the controls. In Group 1, AaDpO2 drastically decreased on days 3—4, which took place in parallel with an increase in the oxygenation index. At the beginning of the study, pulmonary shunting was high in the group of survivors, deceased, and controls. In Group 1, the shunting decreased on days 3—4 whereas in the control group this index normalized later — only by days 6—7. In Group 1, compliance remained lower throughout the observation, but on day 7 there was a significant difference in this index between the deceased, survivors, and controls. Conclusion. Thus, more severe baseline pulmonary gas exchange abnormalities are observed in obstetric patients than in general surgical and traumatological patients; the oxygenation index, alveolar-arterial oxygen difference, and pulmonary shunting index more rapidly change in patients with severe obstetric disease in its favorable course than in general surgical and traumatological patients; throughout the observation, thoracopulmonary compliance was less in obstetric patients than in the controls. Key words: acute respiratory distress syndrome, puerperium.

Obstetrical APS : Is there a place for hydroxychloroquine to improve the pregnancy outcome?

NARCIS (Netherlands)

Mekinian, Arsene; Costedoat-Chalumeau, Nathalie; Masseau, Agathe; Tincani, Angela; De Caroli, Sara; Alijotas-Reig, Jaume; Ruffatti, Amelia; Ambrozic, Ales; Botta, Angela; Le Guern, Véronique; Fritsch-Stork, Ruth; Nicaise-Roland, Pascale; Carbonne, Bruno; Carbillon, Lionel; Fain, Olivier

2015-01-01

The use of the conventional APS treatment (the combination of low-dose aspirin and LMWH) dramatically improved the obstetrical prognosis in primary obstetrical APS (OAPS). The persistence of adverse pregnancy outcome raises the need to find other drugs to improve obstetrical outcome.

The role of women on Dutch farms

NARCIS (Netherlands)

Meulen, van der H.A.B.; Terluin, I.J.; Matser, I.A.

2015-01-01

In this paper an analysis is made of the contribution of women to labour input and management on Dutch farms. We used a written survey among the participants of the Dutch Farm Accountancy Data Network (FADN), in-depth interviews and a group discussion with farm women. Over half of the women on Dutch

The New Dutch ‘Base Exemption Regime’ and the Spirit of the Internal Market

OpenAIRE

Wilde, Maarten; Wisman, Ciska

2013-01-01

textabstractAs of 1 January 2012, the Dutch corporate income tax (‘CIT’) system provides for international juridical double tax relief (‘DTR’) under a mechanism referred to in Dutch tax practice as the ‘base exemption for foreign business profits’1 (author’s translation).2 The newly introduced DTR mechanism replaces the Dutch-style ‘tax exemption with progression method’3 in the area of corporate taxation regarding proceeds derived from foreign-source business activities. The rationale for th...

Adolescent alcohol intoxication in the dutch hospital departments of pediatrics: A 2-year comparison study

NARCIS (Netherlands)

Hoof, J.J. van; Lely, N. van der; Bouthoorn, S.H.; Dalen, W.E. van; Pereira, R.R.

2011-01-01

Purpose: To monitor the prevalence of, and the circumstances leading to, adolescent alcohol intoxication admissions in Dutch hospital departments of pediatrics. Methods: Data were collected in 2007 and 2008, using the Dutch Pediatric Surveillance System, in which pediatricians received

Obstetric outcome with low molecular weight heparin therapy during pregnancy.

LENUS (Irish Health Repository)

Donnelly, J

2012-01-01

This was a prospective study of women attending a combined haematology\\/obstetric antenatal clinic in the National Maternity Hospital (2002-2008). Obstetric outcome in mothers treated with low molecular weight heparin (LMWH) was compared to the general obstetric population of 2006. There were 133 pregnancies in 105 women. 85 (63.9%) received prophylactic LMWH and 38 (28.6%) received therapeutic LMWH in pregnancy. 10 (7.5%) received postpartum prophylaxis only. The perinatal mortality rate was 7.6\\/1000 births. 14 (11.3%) women delivered preterm which is significantly higher than the hospital population rate (5.7%, p<0.05). Despite significantly higher labour induction rates (50% vs 29.2% p<0.01), there was no difference in CS rates compared to the general hospital population (15.4% vs 18.9%, NS). If carefully managed, these high-risk women can achieve similar vaginal delivery rates as the general obstetric population.

Proxy magnetometry with the Dutch Open Telescope

NARCIS (Netherlands)

Rutten, R.J.; Hammerschlag, R.H.; Sütterlin, P.; Bettonvil, F.C.M.

1999-01-01

Superb movies from the Dutch Open Telescope (DOT) on La Palma have proven the validity of the open concept of this innovative telescope for high-resolution imaging of the solar atmosphere. A five- camera speckle-burst registration system is being installed that should permit consistent and

Blood transfusion practices in obstetric anaesthesia

Directory of Open Access Journals (Sweden)

Ashok Jadon

2014-01-01

Full Text Available Blood transfusion is an essential component of emergency obstetric care and appropriate blood transfusion significantly reduces maternal mortality. Obstetric haemorrhage, especially postpartum haemorrhage, remains one of the major causes of massive haemorrhage and a prime cause of maternal mortality. Blood loss and assessment of its correct requirement are difficult in pregnancy due to physiological changes and comorbid conditions. Many guidelines have been used to assess the requirement and transfusion of blood and its components. Infrastructural, economic, social and religious constraints in blood banking and donation are key issues to formulate practice guidelines. Available current guidelines for transfusion are mostly from the developed world; however, they can be used by developing countries keeping available resources in perspective.

[Obstetric Nurses: contributions to the objectives of the Millennium Development Goals].

Science.gov (United States)

Reis, Thamiza da Rosa Dos; Zamberlan, Cláudia; Quadros, Jacqueline Silveira de; Grasel, Jessica Torres; Moro, Adriana Subeldia Dos Santos

2015-01-01

To characterize and analyze assistance to labor and delivery performed by residents in Obstetric Nursing. Quantitative and retrospective study of 189 normal births attended by residents in Obstetric Nursing in the period between July 2013 and June 2014 in a maternity hospital located in the countryside of Rio Grande do Sul. Data collection took place by gathering information from medical records and the analysis was performed using descriptive statistics. It was found the wide use of non-invasive and non-pharmacological pain relief and freedom of position during labor. It is noteworthy that 55.6% of women have not undergone any obstetric intervention. It was possible to identify that the Nursing Residency Program allows the reduction of obstetrical interventions, reflecting directly in the improvement of maternal health.

Local health workers’ perceptions of substandard care in the management of obstetric hemorrhage in rural Malawi

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Beltman Jogchum Jan

2013-02-01

Full Text Available Abstract Background To identify factors contributing to the high incidence of facility-based obstetric hemorrhage in Thyolo District, Malawi, according to local health workers. Methods Three focus group discussions among 29 health workers, including nurse-midwives and non-physician clinicians (‘medical assistants’ and ‘clinical officers’. Results Factors contributing to facility-based obstetric hemorrhage mentioned by participants were categorized into four major areas: (1 limited availability of basic supplies, (2 lack of human resources, (3 inadequate clinical skills of available health workers and (4 substandard referrals by traditional birth attendants and lack of timely self-referrals of patients. Conclusion Health workers in this district mentioned important community, system and provider related factors that need to be addressed in order to reduce the impact of obstetric hemorrhage.

Dutch Colonial Nostalgia Across Decolonisation

NARCIS (Netherlands)

Bijl, P.

2013-01-01

This article argues that nostalgia for colonialism in the Netherlands, the so called tempo doeloe culture, is not a specifically postcolonial phenomenon caused by the collapse of the Dutch empire in Asia. In fact, nostalgia for the Dutch East Indies can be traced back to the nineteenth century, when

The need to include obstetric nurses in prenatal care visits in the public health system

Directory of Open Access Journals (Sweden)

Selma Aparecida Lagrosa Garcia

2010-06-01

Full Text Available Objective: To investigate, with a qualitative approach, the role of Obstetric Nurses at the primary level of care given to women’s health as a vital component of the multidisciplinary team, which today is fundamental for providing care, prevention as well as health education and promotion, especially in programs whose activities are geared towards primary care of pregnant, parturient, and puerpera women. Methods: Brazilian laws and the determinations of Nursing Councils in reference to the activities of the obstetric nurse were researched, including the nurse’s responsibilities and limits. The bibliographic search was conducted in health-related journals, lay publications, and the Internet. Results: The conflicts between professional physicians and nurses were discussed. Conclusions: It was concluded that the activities of the nurse, conducting low-risk prenatal clinical visits in the basic healthcare network, has legal and ethical support and provides true benefit to the clients.

Controversies concerning the antiphospholipid syndrome in obstetrics.

Science.gov (United States)

Camarena Cabrera, Dulce María Albertina; Rodriguez-Jaimes, Claudia; Acevedo-Gallegos, Sandra; Gallardo-Gaona, Juan Manuel; Velazquez-Torres, Berenice; Ramírez-Calvo, José Antonio

Antiphospholipid antibody syndrome is a non-inflammatory autoimmune disease characterized by recurrent thrombotic events and/or obstetric complications associated with the presence of circulating antiphospholipid antibodies (anticardiolipin antibodies, anti-β 2 glycoprotein-i antibodies, and/or lupus anticoagulant. Antiphospholipid antibodies are a heterogeneous group of autoantibodies associated with recurrent miscarriage, stillbirth, fetal growth restriction and premature birth. The diversity of the features of the proposed placental antiphospholipid antibodies fingerprint suggests that several disease processes may occur in the placentae of women with antiphospholipid antibody syndrome in the form of immune responses: inflammatory events, complement activation, angiogenic imbalance and, less commonly, thrombosis and infarction. Because of the disparity between clinical and laboratory criteria, and the impact on perinatal outcome in patients starting treatment, we reviewed the aspects of antiphospholipid antibody syndrome related to obstetric complications and seronegative antiphospholipid antibody syndrome, and their treatment in obstetrics. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Workforce planning and training in Obstetrics and Gynaecology across Europe

DEFF Research Database (Denmark)

Aabakke, Anna J M; Kristufkova, Alexandra; Boyon, Charlotte

2017-01-01

OBJECTIVE(S): To describe the infrastructural differences in training in Obstetrics and Gynaecology (ObGyn) across Europe. STUDY DESIGN: Descriptive web-based survey of 31 national ObGyn trainee societies representing the 30 member countries of the European Network of Trainees in Obstetrics and G...

Obstetric Risk Factors and Subsequent Mental Health Problems in a ...

African Journals Online (AJOL)

Background: Studies suggest that obstetric complications are associated with several child psychiatric conditions. In planning for child psychiatric services it is important to monitor patterns of morbidity and associated risk factors. Identifying obstetric risk factors in a newly opened child psychiatric clinic population with ...

[Selective embolization to treat obstetric hemorrhage].

Science.gov (United States)

Ferrer Puchol, M D; Lanciego, C; Esteban, E; Ciampi, J J; Edo, M A; Ferragud, S

2014-01-01

To describe cases of obstetric hemorrhage that have called for selective intra-arterial embolization and the different embolization techniques used. To assess the clinical outcomes and postprocedural fertility. We studied 27 women with obstetric hemorrhage. In 24 patients, embolization was performed by catheterizing both uterine arteries and in 2 patients only one uterine artery was catheterized (pseudoaneurysm). The materials used for embolization consisted of Spongostan in 17/27, particles in 9/27, and coils in 1/27. Clinical follow-up included an analysis of early and late complications and of postprocedural fertility. Hemorrhage was classified as primary (25/27) or secondary (2/27). The cause of bleeding was vaginal delivery (20), cesarean sections (5), abortion (1), and cervical ectopic pregnancy (1). The initial technical success rate was 100% and the clinical success rate was 92.6% (25 of the 27 patients). Bleeding ceased and the outcome was satisfactory in 25 patients. During clinical follow-up ranging from one to seven years, 23 patients had normal menstruation and 6 patients completed 7 full-term pregnancies. Intra-arterial embolization for obstetric hemorrhage leads to good outcomes and few complications and it preserves fertility. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

Pulse Oximetry Screening Adapted to a System with Home Births: The Dutch Experience

Directory of Open Access Journals (Sweden)

Ilona C. Narayen

2018-03-01

Full Text Available Neonatal screening for critical congenital heart defects is proven to be safe, accurate, and cost-effective. The screening has been implemented in many countries across all continents in the world. However, screening for critical congenital heart defects after home births had not been studied widely yet. The Netherlands is known for its unique perinatal care system with a high rate of home births (18% and early discharge after an uncomplicated delivery in hospital. We report a feasibility, accuracy, and acceptability study performed in the Dutch perinatal care system. Screening newborns for critical congenital heart defects using pulse oximetry is feasible after home births and early discharge, and acceptable to mothers. The accuracy of the test is comparable to other early-screening settings, with a moderate sensitivity and high specificity.

Experience and Enlightenment of Dutch Agricultural Research and Technology

OpenAIRE

Liu Zhen, Zhen; Hu, D.

2011-01-01

This study analyzes the achievements of agricultural science and technology, the reform of agricultural research system and technology transfer system of agricultural in the Netherlands. With case studies, it tries to find the mode of Dutch agricultural research and technology transfer system, and aims to provide suggestions to optimize agricultural research and technology transfer system in China.

Shouting in a Desert: Dutch missionary encounters with Javanese Islam, 1850-1910 : Dutch missionary encounters with Javanese Islam, 1850-1910

NARCIS (Netherlands)

M.J. Kruithof (Maryse)

2014-01-01

markdownabstract__Abstract__ ‘‘Shouting in a desert’ Dutch missionary encounters with Javanese Islam’ concentrates on the shifts and developments in the Dutch mission discourse within the period from 1850 to 1910. It explores the Dutch missionary encounter with local communities and is conducted

Do Dutch Musea Compete Or Cooperate?

OpenAIRE

Thomas De Graaff; Jaap Boter; Jan Rouwendal

2006-01-01

This paper looks into the effect of distance on market shares of Dutch museums. To this end, we assume a generic distance decay function for all museums. In addition, we allow for spatial dependence between museums to account for local competition or synergy effects. Using a unique transaction database with the visiting behavior of 80,821 museum cardholders to 108 Dutch museums, we are able to calculate market shares of each museum in all 484 Dutch municipalities. To account for possible meas...

The Implementation of the AIFMD in Dutch Tax Law

NARCIS (Netherlands)

Vermeulen, H.; Elink Schuurman, J.H.

2014-01-01

In this article, the authors explain the amendments to Dutch tax law as a result of the recent implementation of the Alternative Investment Fund Managers Directive. Changes were made to the Dutch Corporate Income Tax Act, the Dutch Dividend Withholding Tax Act and the Dutch General Tax Act. Given

New pedestrian facilities : technique, observations and opinions : the Dutch experiment. DRIVE project V1061 : pussycats.

NARCIS (Netherlands)

Levelt, P.M.B.

1993-01-01

This report is the Dutch part of an international (French-British-Dutch) evaluation study of new pedestrian crossing facilities, summarized under the name 'PUSSYCATS' (See also IRRD 859331). 'PUSSYCATS' is a new system, characterized by technical improvements better adapted to the behaviour and

Obstetric care of new European migrants in Scotland: an audit of antenatal care, obstetric outcomes and communication.

Science.gov (United States)

Bray, J K; Gorman, D R; Dundas, K; Sim, J

2010-08-01

There has been a twelve-fold increase in the number of New European migrants giving birth in Lothian between 2004 and 2007. The objective of this study was to audit obstetric care standards in Lothian for new migrants and recommend service improvements. A retrospective audit of 114/136 (84%) obstetric case records of new European migrants giving birth in Lothian hospitals in 2006 was conducted. Assessment was against care standards for antenatal booking, antenatal attendance and interpretation. Obstetric outcomes were audited against the general population. Eighty percent were primiparous. Fifty five percent had booked by the end of week 14. Mean birth weights and lengths of stay were similar to the general population. Intervention rates were 23% for Caesarean Sections (C/S) and 17% for instrumental deliveries (versus 27% and 19% respectively in the general population). Epidural or spinal anaesthesia was used for 57% compared to 50% of the general population. The interpretation services (ITS) were used infrequently. Full compliance with antenatal and interpretation standards was not achieved for this population. ITS was most commonly used to meet the needs of healthcare professionals, rather than as a routine. While there were no significant differences in maternity outcomes, poor communication did affect care.

Total greenhouse gas emissions related to the Dutch crop production system

NARCIS (Netherlands)

Kramer, K.J.; Moll, H.C.; Nonhebel, S.

1999-01-01

This article discusses the greenhouse gas emissions (CO2, CH4, N2O) related to Dutch agricultural crop production. Emissions occur during agricultural processes (direct emissions) as well as in the life cycle of the required inputs (indirect emissions). An integrated approach assesses the total

The New Dutch ‘Base Exemption Regime’ and the Spirit of the Internal Market

NARCIS (Netherlands)

M.F. de Wilde (Maarten); C. Wisman (Ciska)

2013-01-01

textabstractAs of 1 January 2012, the Dutch corporate income tax (‘CIT’) system provides for international juridical double tax relief (‘DTR’) under a mechanism referred to in Dutch tax practice as the ‘base exemption for foreign business profits’1 (author’s translation).2 The newly introduced DTR

Teamwork in obstetric critical care.

Science.gov (United States)

Guise, Jeanne-Marie; Segel, Sally

2008-10-01

Whether seeing a patient in the ambulatory clinic environment, performing a delivery or managing a critically ill patient, obstetric care is a team activity. Failures in teamwork and communication are among the leading causes of adverse obstetric events, accounting for over 70% of sentinel events according to the Joint Commission. Effective, efficient and safe care requires good teamwork. Although nurses, doctors and healthcare staff who work in critical care environments are extremely well trained and competent medically, they have not traditionally been trained in how to work well as part of a team. Given the complexity and acuity of critical care medicine, which often relies on more than one medical team, teamwork skills are essential. This chapter discusses the history and importance of teamwork in high-reliability fields, reviews key concepts and skills in teamwork, and discusses approaches to training and working in teams.

Prepayment Behavior of Dutch Mortgagors : An Empirical Analysis

NARCIS (Netherlands)

Charlier, E.; van Bussel, A.

2001-01-01

The booming Dutch mortgage market and the development of a promising secondary mortgage market in the Netherlands stress the need for an accurate mortgage prepayment model that incorporates typical Dutch market and contract characteristics.One of those typical Dutch features prescribes that each

Training in motivational interviewing in obstetrics

DEFF Research Database (Denmark)

Lindhardt, Christina L; Rubak, Sune Leisgaard Mørck; Mogensen, Ole

2014-01-01

-adherent interventions). Furthermore, the participants asked fewer closed and more open questions before training in motivational interview. In the assessment of proficiency and competency, most of the participants scored higher after the training in motivational interviewing. CONCLUSIONS: Training in motivational......OBJECTIVE: To examine whether a three day training course in motivational interviewing which is an approach to helping people to change could improve the communication skills of obstetric healthcare professionals in their interaction with obese pregnant women. DESIGN: Intervention study. SETTING......: The Region of Southern Denmark. METHODS: Eleven obstetric healthcare professionals working with obese pregnant women underwent a three day course in motivational interviewing techniques and were assessed before- and after training to measure the impact on their overall performance as well as the effect...

The impact of microgeneration upon the Dutch balancing market

International Nuclear Information System (INIS)

Van der Veen, Reinier A.C.; De Vries, Laurens J.

2009-01-01

The share of microgeneration (power generation at the level of households and small businesses) in the Dutch electricity system continues to grow. Over time, this development may pose a threat to the reliability and efficiency of the Dutch electricity balancing market. We investigated possible changes to the design of the Dutch balancing market that can maintain or even improve upon its current operational performance level. The first step of the research was an analysis of the existing Dutch balancing market. It consists of three main instruments: programme responsibility, the single buyer market for regulating and reserve power (RRP), and imbalance settlement. The balancing market currently functions satisfactorily. Subsequently, the effects of large-scale development of microgeneration in the Netherlands were evaluated with a qualitative scenario analysis. Four microgeneration scenarios and two methods for allocating the household electricity consumption and generation were considered. The four scenarios concerned large-scale penetration of PV, heat-led micro CHP, electricity-led micro CHP operated by the household consumer, and electricity-led micro CHP operated by the supply company. The last scenario was found to have the strongest positive net effect. Finally, six design options were identified for improving the Dutch balancing market design in case the share of microgeneration would increase substantially. Of these six options, adjusting the profile methodology and the regulation of smart meters are no-regret options that can be implemented immediately. The attractiveness of the other options depends upon the microgeneration portfolio that emerges, the manageability of large metering data flows, and the nature of the technical effects of large-scale microgeneration penetration.

Integrating ecosystem services into the tropical timber value chain : Dutch policy options from an innovation system approach

NARCIS (Netherlands)

Berg, van den J.; Ingram, V.J.; Bogaardt, M.J.; Harms, B.

2013-01-01

This WOt Working document explores the governance options available to the Dutch government for the promotion of the sustainable use and maintenance of ecosystem services in tropical timber value chains with Dutch links and how ecosystem services can be given a more explicit place in the public and

Performance of Dutch children on the Bayley III: a comparison study of US and Dutch norms.

Directory of Open Access Journals (Sweden)

Leonie J P Steenis

Full Text Available The Bayley Scales of Infant and Toddler Development-third edition (Bayley-III are frequently used to assess early child development worldwide. However, the original standardization only included US children, and it is still unclear whether or not these norms are adequate for use in other populations. Recently, norms for the Dutch version of the Bayley-III (The Bayley-III-NL were made. Scores based on Dutch and US norms were compared to study the need for population-specific norms.Scaled scores based on Dutch and US norms were compared for 1912 children between 14 days and 42 months 14 days. Next, the proportions of children scoring < 1-SD and < -2 SD based on the two norms were compared, to identify over- or under-referral for developmental delay resulting from non-population-based norms.Scaled scores based on Dutch norms fluctuated around values based on US norms on all subtests. The extent of the deviations differed across ages and subtests. Differences in means were significant across all five subtests (p < .01 with small to large effect sizes (ηp2 ranging from .03 to .26. Using the US instead of Dutch norms resulted in over-referral regarding gross motor skills, and under-referral regarding cognitive, receptive communication, expressive communication, and fine motor skills.The Dutch norms differ from the US norms for all subtests and these differences are clinically relevant. Population specific norms are needed to identify children with low scores for referral and intervention, and to facilitate international comparisons of population data.

Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review.

Science.gov (United States)

Onwochei, Desire N; Halpern, Stephen; Balki, Mrinalini

2017-06-01

Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies. We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data. Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity. More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.

[Japanese who affected modern medicine in Taiwan: obstetrics and gynecology].

Science.gov (United States)

Wang, Ming-Tung

2009-12-01

This text describes the leaders who established the modem obstetrics and gynecology for Taiwan. during the Japan-colonizing period (1895-1945). These leaders are Mr. Kawasoye, M., Mr. Mukae K., and Mr. Magara M. The lives of these leaders were different, but they all strongly contributed to the development of modem obstetrics and gynecology in Taiwan. With regard to the passage of time, Mr. Kawasoye contributed the initial efforts, Mr. Mukae worked during the flourishing period of the clinic; and Mr. Magara worked during the mature period, emphasizing research. These three periods are closely correlated with the course of the development of modem obstetrics and gynecology in Taiwan.

Disentangling an Invisible Trade : state interventions in Dutch and Dutch-Curaçaoan single-mother families

NARCIS (Netherlands)

Verhallen, T.L.

2015-01-01

The doctoral thesis sheds light on the interactional and institutional processes through which child welfare and child protection practices are delivered to fifteen Dutch and fifteen Dutch-Curaçaoan single-mother families with multiple problems in the Netherlands in order to reveal structures of

Nitrogen efficiency of Dutch dairy farms : A shadow cost system approach

NARCIS (Netherlands)

Reinhard, S.; Thijssen, G.J.

2000-01-01

In this paper we analyse the cost efficiency and nitrogen efficiency of an unbalanced panel of Dutch dairy farms. Nitrogen efficiency is defined as the ratio of minimal to observed use of nitrogen (N-containing inputs), conditional on output and quasi-fixed inputs. Nitrogen efficiency is computed in

Making Stone Soup: Evaluating a Recall-Oriented Multi-Stream Question Answering Stream for Dutch

NARCIS (Netherlands)

Ahn, D.D.; Jijkoun, V.; Müller, K.E.; de Rijke, M.; Schlobach, K.S.; Mishne, G.A.; Peters, C.; Clough, P.D.; Jones, G.J.F.; Gonzalo, J.; Kluck, M.; Magnini, B.

2005-01-01

We describe the participation of the University of Amsterdam in the Question Answering track at CLEF 2004.We took part in the monolingual Dutch task and, for the first time, also in the bilingual English to Dutch task. This year¿s system is a further elaboration and refinement of the multi-stream

The Dutch Economy 2009

International Nuclear Information System (INIS)

2010-09-01

In the series 'The Dutch Economy' the Dutch Statistical Office describes and analyzes annual developments in enterprises, households and governments, and with respect to employment and the environment. One of the subjects is 'Economy and Environment' with the sub-topics 'Resources and Energy', 'Emissions' and 'Environmental Taxes'. Furthermore, in articles on specific themes current economic issues are discussed. One of those themes has the title 'Share of renewable energy in the Netherlands is still small'. [nl

Subjective Oral Health in Dutch Adults

Directory of Open Access Journals (Sweden)

Gijsbert H.W. Verrips

2013-05-01

Full Text Available Aim: To determine whether the subjective oral health (SOH of the Dutch adult population was associated with clinical and demographic variables. Methods: A clinical examination was conducted in a sample of 1,018 people from the Dutch city of ‘s-Hertogenbosch. SOH was measured using the Dutch translation of the short form of the Oral Health Impact Profile (OHIP-NL14. Results: The average score on the OHIP-NL14 was 2.8 ± 5.9 and 51% of the respondents had a score of 0. Dental status was the most important predictor of SOH. Conclusions:  The SOH in the Dutch adult population was much better than in groups of adults in Australia, the United Kingdom and New Zealand. Nevertheless, there were important variations in SOH related to dental and socio-economic status.

[Neurologic vigor of term newborns according to the type of delivery and obstetric maneuvers].

Science.gov (United States)

Riesgo, Rudimar dos Santos; Ohlweiler, Lygia; Winckler, Maria Isabel Bragatti; Ranzan, Josiane; Riesgo, Itamar Dos Santos; Rotta, Newra Tellechea

2009-06-01

to evaluate the effect of delivery type and usual obstetric procedures on the neurologic condition of a sample of consecutive term and healthy neonates, in the first 48 hours of life, using the Neurologic Adaptative Capacity Score (NACS) system. cohort prospective study with 313 neonates, from a neonatology unit: Unidade de Neonatologia e Alojamento Conjunto. The variables analyzed were obstetric variables; clinical outcome: low neurologic vigor phase, evaluated by NACS, at 4, 24 and 48 hours of life. The data have been assessed twice: once with the whole sample and the other comparing the Vigorous Group, whose neonates kept a score of 35 or more during the three evaluations, and the Low Vigor Group, with less than 35 scores during the three consecutive evaluations. Bivariate and multivariate analyses have been done. Possible associations between low neurologic vigor phase and the type of delivery, as well between the low neurologic vigor phase and obstetric variables have been searched. in the bivariate analysis, the delivery type and the obstetric variables were not associated with the low neurologic vigor phase. Nevertheless, the association between the amniotic fluid and the low neurologic vigor phase reached values very close to significance and, then, it was included in the multivariate analysis. In the multivariate analysis, the only variable associated with low neurologic vigor was the presence of meconium stained amniotic fluid, which has shown to be 8.1 times more risky for the neurologic scoring, when Vigorous Group and Low Vigor Group were compared. In the analysis of the whole sample, the same risk was 1.7. neither the delivery type, nor the usual obstetric procedures were associated with low neurologic vigor phase. This is useful information, clinically or legally speaking, mainly for obstetricians. According to this sample data, when the term neonate is healthy, the delivery type and the usual obstetric procedures have no impact in the neurologic

How Should Trainees Respond in Situations of Obstetric Violence?

Science.gov (United States)

Rubashkin, Nicholas; Minckas, Nicole

2018-03-01

Argentina passed a law for humanized birth in 2004 and another law against obstetric violence in 2009, both of which stipulate the rights of women to achieve respectful maternity care. Clinicians and women might still be unaware of these laws, however. In this article, we discuss the case of a fourth-year medical student who, while visiting Argentina from the United States for his obstetric rotation, witnesses an act of obstetric violence. We show that the student's situation can be understood as one of moral distress and argue that, in this specific instance, it would be appropriate for the student to intervene by providing supportive care to the patient. However, we suggest that medical schools have an obligation to better prepare students for rotations conducted abroad. © 2018 American Medical Association. All Rights Reserved.

[Anesthesia in obstetrics: Tried and trusted methods, current standards and new challenges].

Science.gov (United States)

Kranke, P; Annecke, T; Bremerich, D H; Hanß, R; Kaufner, L; Klapp, C; Ohnesorge, H; Schwemmer, U; Standl, T; Weber, S; Volk, T

2016-01-01

Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology. The topics are in particular, special features and pitfalls of informed consent in the delivery room, challenges in education and training in obstetric anesthesia, expedient inclusion of simulation-assisted training and further education on risk minimization, knowledge and recommendations on fasting for the delivery room and cesarean sections, monitoring in obstetric anesthesia by neuraxial and alternative procedures, the possibilities and limitations of using ultrasound for lumbal epidural catheter positioning in the delivery room, recommended approaches in preparing peridural catheters for cesarean section, basic principles of cardiotocography, postoperative analgesia after cesarean section, the practice of early bonding in the delivery room during cesarean section births and the management of postpartum hemorrhage.

Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries.

Science.gov (United States)

Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

2018-06-01

services" (≥30% of facility deliveries) were only found in three countries. The low levels of availability, readiness and coverage of obstetric services documented represent substantial missed opportunities within health systems. Global and national efforts need to prioritize upgrading EmOC functionality and improving readiness to deliver obstetric service, particularly in rural areas. The approach of linking health facility and household surveys described here could facilitate the tracking of progress towards quality obstetric care.

Reforming Dutch substance abuse treatment services.

Science.gov (United States)

Schippers, Gerard M; Schramade, Mark; Walburg, Jan A

2002-01-01

The Dutch substance abuse treatment system is in the middle of a major reorganization. The goal is to improve outcomes by redesigning all major primary treatment processes and by implementing a system of regular monitoring and feedback of clinical outcome data. The new program includes implementing standardized psychosocial behavior-oriented treatment modalities and a stepped-care patient placement algorithm in a core-shell organizational model. This article outlines the new program and presents its objectives, developmental stages, and current status.

Inherited thrombophilia in women with poor aPL-related obstetric history: prevalence and outcomes. Survey of 208 cases from the European Registry on Obstetric Antiphospholipid Syndrome cohort.

Science.gov (United States)

Alijotas-Reig, Jaume; Ferrer-Oliveras, Raquel; Esteve-Valverde, Enrique; Ruffatti, Amelia; Tincani, Angela; Lefkou, Elmina; Bertero, Maria Tiziana; Espinosa, Gerard; Coloma, Emmanuel; de Carolis, Sara; Rovere-Querini, Patrizia; Canti, Valentina; Picardo, Elisa; Fredi, Micaela; Mekinian, Arsene

2016-08-01

To analyse the prevalence and effects of inherited thrombophilic disorders (ITD) on maternal-foetal outcomes in cases of antiphospholipid antibody related to obstetric complications. Women with obstetric complaints who tested positive for aPL and with inherited thrombophilia were prospectively and retrospectively included. ITD data were available in 208 of 338: 147 had obstetric antiphospholipid syndrome (OAPS) and 61 aPL-related obstetric morbidity (OMAPS). 24.1% had ITD. Laboratory categories I and IIa were more related to OAPS-ITD and IIb and IIc to OMAPS-ITD. No significant differences in obstetric complaints were observed. Regarding ITD carriers, treatment rates were higher in OAPS than in OMAPS for LMWH and LDA plus LMWH (P=.002). Cases with aPL-related OAPS/OMAPS showed no differences in maternal-foetal outcomes regardless of the presence of one ITD. Maternal thrombotic risk was low, with ITD-positive cases included. Registry data concur with Sydney criteria, whereby aPL-ITD-positive patients are classified as having antiphospholipid syndrome. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The design and implementation of an obstetric triage system for unscheduled pregnancy related attendances: a mixed methods evaluation.

Science.gov (United States)

Kenyon, Sara; Hewison, Alistair; Dann, Sophie-Anna; Easterbrook, Jolene; Hamilton-Giachritsis, Catherine; Beckmann, April; Johns, Nina

2017-09-18

No standardised system of triage exists in Maternity Care and local audit identified this to be problematic. We designed, implemented and evaluated an Obstetric Triage System in a large UK maternity unit. This includes a standard clinical triage assessment by a midwife, within 15 min of attendance, leading to assignment to a category of clinical urgency (on a 4-category scale). This guides timing of subsequent standardised immediate care for the eight most common reasons for attendance. A training programme was integral to the introduction. A mixed methods evaluation was conducted. A structured audit of 994 sets of maternity notes before and after implementation identified the number of women seen within 15 min of attendance. Secondary measures reviewed included time to subsequent care and attendance. An inter-operator reliability study using scenarios was completed by midwives. A focus group and two questionnaire studies were undertaken to explore midwives' views of the system and to evaluate the training. In addition a national postal survey of practice in UK maternity units was undertaken in 2015. The structured audit of 974/992 (98%) of notes demonstrated an increase in the number of women seen within 15 min of attendance from 39% before implementation to 54% afterwards (RR (95% CI) 1.4 (1.2, 1.7) p = reliability (ICC 0.961 (95% CI 0.91-0.99)) was demonstrated with breakdown showing consistently good rates. Thematic analysis of focus group data (n = 12) informed the development of the questionnaire which was sent to all appropriate midwives. The response rate was 53/79 (67%) and the midwives reported that the new system helped them manage the department and improved safety. The National Survey (response rate 85/135 [63%]) demonstrated wide variation in where women are seen and staffing models in place. The majority of units 69/85 (81%) did not use a triage system based on clinical assessment to prioritise care. This obstetric triage system has excellent

Existence and functionality of emergency obstetric care services at district level in Kenya

DEFF Research Database (Denmark)

Echoka, Elizabeth; Kombe, Yeri; Dubourg, Dominique

2013-01-01

The knowledge on emergency obstetric care (EmOC) is limited in Kenya, where only partial data from sub-national studies exist. The EmOC process indicators have also not been integrated into routine health management information system to monitor progress in safe motherhood interventions both...

[Antiphospholipid syndrome and pregnancy: Obstetrical prognosis according to the type of APS].

Science.gov (United States)

Delesalle, C; de Vienne, C; Le Hello, C; Verspyck, E; Dreyfus, M

2015-05-01

The objective of our study was to compare treatment-based obstetrical outcomes in women with either thrombotic or obstetrical antiphospholipid syndrome (APS). This was a historical cohort study conducted between 1998 and 2009 in 23 patients who had a total of 83 pregnancies. The syndrome was diagnosed using the 2006 Sapporo criteria. Thirty-one of these 83 pregnancies were valid before the diagnosis was made. A live infant was born in 22% of them, the infant being small for gestational age in 26% of cases. The fetus died in utero in a further 26% of cases. Pregnancies were subdivided into 2 groups depending on whether the initial event leading to APS diagnosis was obstetrical or thrombotic. Treatment (aspirin and low molecular weight heparin) was based on this classification: the latter was given in a curative dose for thrombotic events, in a preventive dose for obstetrical events. No fetal loss was observed when treatment was administered according to the protocol. Nevertheless, 20% of the pregnancies with obstetrical APS were complicated by smallness for gestational age and only 38% of the infants were live births. More than 87% of the thrombotic forms treated were free of complications and led to birth of a living child. Appropriate treatment appears to improve the prognosis for pregnancies in patients with APS. These patients are nevertheless at increased risk of an obstetrical event and require close monitoring, especially in obstetrical manifestations, which appear to have a poorer prognosis. Multidisciplinary follow-up by an experienced team is essential. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

[Rapid Response obstetrics Team at Instituto Mexicano del Seguro Social,enabling factors].

Science.gov (United States)

Dávila-Torres, Javier; González-Izquierdo, José de Jesús; Ruíz-Rosas, Roberto Aguli; Cruz-Cruz, Polita Del Rocío; Hernández-Valencia, Marcelino

2015-01-01

There are barriers and enablers for the implementation of Rapid Response Teams in obstetric hospitals. The enabling factors were determined at Instituto Mexicano del Seguro Social (IMSS) MATERIAL AND METHODS: An observational, retrospective study was conducted by analysing the emergency obstetric reports sent by mobile technology and e-mail to the Medical Care Unit of the IMSS in 2013. Frequency and mean was obtained using the Excel 2010 program for descriptive statistics. A total of 164,250 emergency obstetric cases were reported, and there was a mean of 425 messages per day, of which 32.2% were true obstetric emergencies and required the Rapid Response team. By e-mail, there were 73,452 life threatening cases (a mean of 6 cases per day). A monthly simulation was performed in hospitals (480 in total). Enabling factors were messagés synchronisation among the participating personnel,the accurate record of the obstetrics, as well as the simulations performed by the operational staff. The most common emergency was pre-eclampsia-eclampsia with 3,351 reports, followed by obstetric haemorrhage with 2,982 cases. The enabling factors for the implementation of a rapid response team at IMSS were properly timed communication between the central delegation teams, as they allowed faster medical and administrative management and participation of hospital medical teams in the process. Mobile technology has increased the speed of medical and administrative management in emergency obstetric care. However, comparative studies are needed to determine the statistical significance. Published by Masson Doyma México S.A.

Home Bias and Dutch Pension Funds’ Investment behaviour

NARCIS (Netherlands)

Verschoor, W.F.C.; Rubbaniy, G.; Lelyveld van, I.P.P.

2014-01-01

Using a panel data set of more than 600 Dutch pension funds (PFs) between 1992 and 2006, we investigate asset allocation behavior of Dutch PFs across multiple asset classes. We find that domestic investments, also known as home bias, in portfolio choices of Dutch institutional investors have fallen.

What's new and novel in obstetric anesthesia? Contributions from the 2003 scientific literature.

Science.gov (United States)

Tsen, L C

2005-04-01

THE PREGNANT PATIENT: Age; maternal disease; prophylactic antibiotics; gastroesophageal reflux; obesity; starvation; genotyping; coagulopathy; infection; substance abuse; altered drug responses in pregnancy; physiological changes of pregnancy. THE FETUS: Fetal monitoring; intrauterine surgery. THE NEWBORN: Breastfeeding; maternal infection, fever, and neonatal sepsis evaluation. OBSTETRIC COMPLICATIONS: Embolic phenomena; hemorrhage; preeclampsia; preterm delivery. OBSTETRIC MANAGEMENT: External cephalic version and cervical cerclage; elective cesarean delivery; fetal malpresentation; vaginal birth after cesarean delivery; termination of pregnancy. OBSTETRIC ANESTHESIA: Analgesia for labor and delivery; anesthesia for cesarean delivery; anesthesia for short obstetric operations; complications of anesthesia. MISCELLANEOUS: Consent; ethics; history; labor support; websites/books/leaflets/journal announcements.

The Dutch Deposit of Electronic Publications (DNEP - 1995-2000

Directory of Open Access Journals (Sweden)

Lex Sijtsma

2001-07-01

Full Text Available In 1993 the Internet took off with the introduction of HTML and the first browser (Mosaic. Two years later, in 1995, the Koninklijke Bibliotheek (KB decided to start a series of experiments and projects which would lead to a deposit system for Dutch Electronic Publications. In the same year the KB made a policy decision to include electronic material into its deposit. That marked the start of the Dutch Deposit for Electronic Publications (DNEP. Both as an operational service and at the same time as a test-bed for research into digital archiving. Early 1999 a Request For Information (RFI was sent out to selected companies. This was done to establish whether the functionalities the KB deemed neccessary for a digital deposit were available in the marketplace. On the basis of the positive outcome of this Request a European Tender was started. The KB developed a process model for a digital deposit as well as detailed functional requirements for such a system. A supplier, IBM, was selected. At the moment (early June 2000 talks about the implementation are in progress. The project will start in the summer of start of autumn of 2000 and will take 24 months. The Dutch government has acknowledged that the establishment of the Dutch electronic bibliography and the DNEP itself are indeed tasks of the Koninklijke Bibliotheek. We expect that appropriate structural funding to supports these tasks will become available. In this paper an overview is given of what the KB has done since 1995 up till now and how this has led to the implementation-project that is about to start.

Obstetric Emergencies: Shoulder Dystocia and Postpartum Hemorrhage.

Science.gov (United States)

Dahlke, Joshua D; Bhalwal, Asha; Chauhan, Suneet P

2017-06-01

Shoulder dystocia and postpartum hemorrhage represent two of the most common emergencies faced in obstetric clinical practice, both requiring prompt recognition and management to avoid significant morbidity or mortality. Shoulder dystocia is an uncommon, unpredictable, and unpreventable obstetric emergency and can be managed with appropriate intervention. Postpartum hemorrhage occurs more commonly and carries significant risk of maternal morbidity. Institutional protocols and algorithms for the prevention and management of shoulder dystocia and postpartum hemorrhage have become mainstays for clinicians. The goal of this review is to summarize the diagnosis, incidence, risk factors, and management of shoulder dystocia and postpartum hemorrhage. Copyright © 2017 Elsevier Inc. All rights reserved.

De relatieve duurzaamheid van de Nederlandse roodvleessector: een kwalitatieve vergelijking = A comparative study on the sustainability of the Dutch beef cattle production sector

NARCIS (Netherlands)

Bos, A.P.

2015-01-01

In this study the sustainability of Dutch specialized beef production is compared qualitatively with two other Dutch animal production systems (porc and broilers), and with beef production in Ireland and Brazil, the most prominent exporters of beef to the Dutch market with which the Dutch sector

Antibiotic prophylaxis in obstetric procedures.

Science.gov (United States)

van Schalkwyk, Julie; Van Eyk, Nancy

2010-09-01

To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures. Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures. Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and articles published from January 1978 to June 2009 were incorporated in the guideline. Current guidelines published by the American College of Obstetrics and Gynecology were also incorporated. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Implementation of this guideline should reduce the cost and harm resulting from the administration of antibiotics when they are not required and the harm resulting from failure to administer antibiotics when they would be beneficial. SUMMARY STATEMENTS: 1. Available evidence does not support the use of prophylactic antibiotics to reduce infectious morbidity following operative vaginal delivery. (II-1) 2. There is insufficient evidence to argue for or against the use of prophylactic antibiotics to reduce infectious morbidity for manual removal of the placenta. (III) 3. There is insufficient evidence to argue for or against the use of

A memory-based shallow parser for spoken Dutch

NARCIS (Netherlands)

Canisius, S.V.M.; van den Bosch, A.; Decadt, B.; Hoste, V.; De Pauw, G.

2004-01-01

We describe the development of a Dutch memory-based shallow parser. The availability of large treebanks for Dutch, such as the one provided by the Spoken Dutch Corpus, allows memory-based learners to be trained on examples of shallow parsing taken from the treebank, and act as a shallow parser after

Assessing transition trajectories towards a sustainable energy system: A case study on the Dutch transition to climate-neutral transport fuel chains

NARCIS (Netherlands)

Suurs, R.A.A.; Hekkert, M.P.; Meeus, M.T.H.; Nieuwlaar, E.

2004-01-01

This paper proposes a method for the ex ante evaluation of technological trajectories. As a case we study the Dutch transport energy system and its transition to climate neutrality. Two technological trajectories are proposed: (i) a sequence of transition steps based on radical infrastructural

Evaluation of trainees' ability to perform obstetrical ultrasound using simulation: challenges and opportunities.

Science.gov (United States)

Chalouhi, Gihad E; Bernardi, Valeria; Gueneuc, Alexandra; Houssin, Isabelle; Stirnemann, Julien J; Ville, Yves

2016-04-01

Evaluation of trainee's ability in obstetrical ultrasound is a time-consuming process, which requires involving patients as volunteers. With the use of obstetrical ultrasound simulators, virtual reality could help in assessing competency and evaluating trainees in this field. The objective of the study was to test the validity of an obstetrical ultrasound simulator as a tool for evaluating trainees following structured training by comparing scores obtained on obstetrical ultrasound simulator with those obtained on volunteers and by assessing correlations between scores of images and of dexterity given by 2 blinded examiners. Trainees, taking the 2013 French national examination for the practice of obstetrical ultrasound were asked to obtain standardized ultrasound planes both on volunteer pregnant women and on an obstetrical ultrasound simulator. These planes included measurements of biparietal diameter, abdominal circumference, and femur length as well as reference planes for cardiac 4-chamber and outflow tracts, kidneys, stomach/diaphragm, spine, and face. Images were stored and evaluated subsequently by 2 national examiners who scored each picture according to previously established quality criteria. Dexterity was also evaluated and subjectively scored between 0 and 10. The Raghunathan's modification of Pearson, Filon's z, Spearman's rank correlation, and analysis of variance tests were used to assess correlations between the scores by the 2 examiners and scores of dexterity and also to compare the final scores between the 2 different methods. We evaluated 29 trainees. The mean dexterity scores in simulation (6.5 ± 2.0) and real examination (5.9 ± 2.3) were comparable (P = .31). Scores with an obstetrical ultrasound simulator were significantly higher than those obtained on volunteers (P = .027). Nevertheless, there was a good correlation between the scores of the 2 examiners judging on simulation (R = 0.888) and on volunteers (R = 0.873) (P = .81). An

‘A Newspaper War’?: Dutch Information Networks during the South African War (1899-1902

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Vincent Kuitenbrouwer

2013-03-01

Full Text Available The South African War (1899-1902 caused a stir in the Netherlands. The Dutch public overwhelmingly supported the Boers in their struggle against the British. To support the ‘kinsmen’ in South Africa several organisations in the Netherlands embarked on an international propaganda campaign. This article considers the involvement of Dutch journalists in the pro-Boer agitation. They were confronted with a dilemma because as a small country the Netherlands officially was neutral and did not possess strong international lines of communications, which made it difficult to distribute information in other countries. This problem raised moral and practical questions about the Dutch press and its position in the world. Using concepts from the historiography on the media of the British Empire, Kuitenbrouwer analyses the Dutch press system around 1900.

Integrating psychology and obstetrics for medical students: shared labour ward teaching.

Science.gov (United States)

Chalmers, B E; McIntyre, J A

1993-01-01

Two studies relating to the inclusion of psycho-social issues in the training of obstetricians are reported here. The first reports on the extent to which currently practising obstetricians have received training in these aspects. The second explored the value of an innovative teaching approach combining psychological and obstetric training for medical students in the labour ward. A postal survey with responses from 220 obstetricians and paediatricians revealed that little information on psychological aspects of obstetric practice had been included in their undergraduate or postgraduate training or obtained from voluntary continuing education programmes. Experience was the primary source of training in these subjects. The second study explored the impact of joint psychological and obstetric teaching ward rounds for medical students. Students attending these integrated sessions reported being better prepared for the psycho-social aspects of obstetrics and showed a greater awareness of cross-cultural differences in needs of women during birth.

PRONTO training for obstetric and neonatal emergencies in Mexico.

Science.gov (United States)

Walker, Dilys M; Cohen, Susanna R; Estrada, Fatima; Monterroso, Marcia E; Jenny, Alisa; Fritz, Jimena; Fahey, Jenifer O

2012-02-01

To evaluate the acceptability, feasibility, rating, and potential impact of PRONTO, a low-tech and high-fidelity simulation-based training for obstetric and neonatal emergencies and teamwork using the PartoPants low-cost birth simulator. A pilot project was conducted from September 21, 2009, to April 9, 2010, to train interprofessional teams from 5 community hospitals in the states of Mexico and Chiapas. Module I (teamwork, neonatal resuscitation, and obstetric hemorrhage) was followed 3 months later by module II (dystocia and pre-eclampsia/eclampsia) and an evaluation. Four elements were assessed: acceptability; feasibility and rating; institutional goal achievement; teamwork improvement; and knowledge and self-efficacy. The program was rated highly both by trainees and by non-trainees who completed a survey and interview. Hospital goals identified by participants in the module I strategic-planning sessions were achieved for 65% of goals in 3 months. Teamwork, knowledge, and self-efficacy scores improved. PRONTO brings simulation training to low-resource settings and can empower interprofessional teams to respond more effectively within their institutional limitations to emergencies involving women and newborns. Further study is warranted to evaluate the potential impact of the program on obstetric and neonatal outcome. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Accounting for hybridity: Accrual budgeting in the Dutch central government

NARCIS (Netherlands)

Mol, Nico P.; de Kruijf, J.A.M.

2003-01-01

In the Dutch central government (following countries like New Zealand, Australia and the UK) a system of resource budgeting is being developed as a substitute for its present dual system of cash/commitment budgeting for core departments and accrual accounting for executive agencies. Advocates of

Posttraumatic stress and depression may undermine abuse survivors' self-efficacy in the obstetric care setting.

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Stevens, Natalie R; Tirone, Vanessa; Lillis, Teresa A; Holmgreen, Lucie; Chen-McCracken, Allison; Hobfoll, Stevan E

2017-06-01

Posttraumatic stress symptoms (PTS) are associated with increased risk of obstetric complications among pregnant survivors of trauma, abuse and interpersonal violence, but little is known about how PTS affects women's actual experiences of obstetric care. This study investigated the rate at which abuse history was detected by obstetricians, whether abuse survivors experienced more invasive exams than is typically indicated for routine obstetric care, and whether psychological distress was associated with abuse survivors' sense of self-efficacy when communicating their obstetric care needs. Forty-one pregnant abuse survivors completed questionnaires about abuse history, current psychological distress and self-efficacy for communicating obstetric care needs and preferences. Electronic medical records (EMRs) were reviewed to examine frequency of invasive prenatal obstetric procedures (e.g. removal of clothing for external genital examination, pelvic exams and procedures) and to examine the detection rate of abuse histories during the initial obstetric visit. The majority of participants (83%) reported at least one past incident of violent physical or sexual assault. Obstetricians detected abuse histories in less than one quarter of cases. Nearly half of participants (46%) received invasive exams for non-routine reasons. PTS and depression symptoms were associated with lower self-efficacy in communicating obstetric care preferences. Women most at risk for experiencing distress during their obstetric visits and/or undergoing potentially distressing procedures may also be the least likely to communicate their distress to obstetricians. Results are discussed with implications for improving screening for abuse screening and distress symptoms as well as need for trauma-sensitive obstetric practices.

o. Setting. On Reconstructing Variation in Cape Dutch (1710-1840 ...

African Journals Online (AJOL)

European languages in an extraterritorial ... extraterritorial varieties of language that developed from contact of diverse metropolitan dialects (and ..... The Netherlandic perfect auxiliary system remains largely intact in mesolectal Cape Dutch, although.

A Pain Beyond Childbirth: Obstetrical Violence In Focus

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Artenira da Silva e Silva Sauaia

2016-06-01

Full Text Available Obstetric violence is a type of gender violence and it implies violation of human rights, characterized by the imposition of harmful interventions to the physical and psychological integrity of pregnant women, perpetrated by health professionals and institutions (public and private in which such women are assisted. Thus, this paper has as the purpose to discuss obstetric violence as well as its characterization through the judgments of the Supreme Federal Court (STF and the Superior Court of Justice (STJ. The judgments with more evidence about the theme were selected and discussed.

[Husband's presence at childbirth in light of obstetric psychoprophylaxis].

Science.gov (United States)

Sioma-Markowska, Urszula; Sipiński, Adam; Majerczyk, Iwona; Selwet, Monika; Kuna, Anna; Machura, Mariola

2004-01-01

Contemporary obstetric psychoprophylaxis gives prospective parents wide opportunities to prepare to the pregnancy period and delivery. It is educationally-minded and points the importance to modify the life style, introduces exercises accompanied by the relative during the pregnancy and delivery. The survey portrays husband's--child father's role in obstetric psychoprophylaxis. The importance to continue the psychoprophylaxis in the delivery room was spotted in the survey, too. The continuation might be reached by close relative's presence.

Vaginal versus Obstetric Infection Escherichia coli Isolates among Pregnant Women: Antimicrobial Resistance and Genetic Virulence Profile.

Science.gov (United States)

Sáez-López, Emma; Guiral, Elisabet; Fernández-Orth, Dietmar; Villanueva, Sonia; Goncé, Anna; López, Marta; Teixidó, Irene; Pericot, Anna; Figueras, Francesc; Palacio, Montse; Cobo, Teresa; Bosch, Jordi; Soto, Sara M

2016-01-01

Vaginal Escherichia coli colonization is related to obstetric infections and the consequent development of infections in newborns. Ampicillin resistance among E. coli strains is increasing, which is the main choice for treating empirically many obstetric and neonatal infections. Vaginal E. coli strains are very similar to extraintestinal pathogenic E. coli with regards to the virulence factors and the belonging to phylogroup B2. We studied the antimicrobial resistance and the genetic virulence profile of 82 E. coli isolates from 638 vaginal samples and 63 isolated from endometrial aspirate, placental and amniotic fluid samples from pregnant women with obstetric infections. The prevalence of E. coli in the vaginal samples was 13%, which was significant among women with associated risk factors during pregnancy, especially premature preterm rupture of membranes (pinfections showed higher resistance levels than vaginal isolates, particularly for gentamicin (p = 0.001). The most prevalent virulence factor genes were those related to the iron uptake systems revealing clear targets for interventions. More than 50% of the isolates belonged to the virulent B2 group possessing the highest number of virulence factor genes. The ampicillin-resistant isolates had high number of virulence factors primarily related to pathogenicity islands, and the remarkable gentamicin resistance in E. coli isolates from women presenting obstetric infections, the choice of the most appropriate empiric treatment and clinical management of pregnant women and neonates should be carefully made. Taking into account host-susceptibility, the heterogeneity of E. coli due to evolution over time and the geographical area, characterization of E. coli isolates colonizing the vagina and causing obstetric infections in different regions may help to develop interventions and avoid the aetiological link between maternal carriage and obstetric and subsequent puerperal infections.

Obstetrics

International Nuclear Information System (INIS)

Hricak, H.

1987-01-01

Ultrasound will remain the primary modality for evaluating the obstetrical patient. MRI, however, is a useful adjunct when sonography cannot provide sufficient information. Currently, the use of MRI is limited to late pregnancy with the following indications: (a) evaluation of marginal placenta previa; (b) determination of IUGR; (c) assessment of cervical effacement; (d) fetal anomalies of the CNS; and (e) evaluation of concomitant maternal neoplasms. Specific advantages of MRI include: 1. Provision of crucial information in patients with a medical or surgical condition that ordinarily would require ionizing radiation. 2. Provision of important data about fetal anomalies and growth and development when sonography is limited by oligohydramnios or maternal obesity. 3. Confirmation of fetal anomalies when US is equivocal. 4. Demonstration of maternal pelvic structures when US is unsuccessful due to overlying bowel gas or obesity. 5. Pelvimetry without ionizing radiation

Lesjes van de Nederlanders: Little Lessons from the Dutch to Promote Educational Quality. AIR 1995 Annual Forum Paper.

Science.gov (United States)

Palmer, Barbara H.

This study explored quality assessment and accountability in Dutch university education using a case study approach. The Dutch national system of quality assurance is described, and developments since the mid-1980s are traced. The university case studies illustrate models which are being employed to implement the quality assurance system including…

Dutch word stress as pronounced by Indonesian students

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Lilie M. Roosman

2009-10-01

Full Text Available This study focuses on the way in which the Dutch monophthongal vowels are pronounced by Indonesian students. To investigate whether Indonesian students realize the Dutch vowels correctly, especially when they are stressed, I analysed duration and quality of stressed and unstressed Dutch vowels. Measurements were done on the duration and the formant frequencies of the vowels spoken by Indonesian students and by native speakers of Dutch as well. Statistical analysis showed that in general the differences in duration between vowels spoken by the Indonesian students and by the native speakers were not significant. However, the effect of stress on the lengthening of the vowels was stronger for the Indonesian students than for the native speakers. In addition, statistical analysis of the formant frequencies confirmed that the non-native speakers realized the Dutch vowels slightly differently from the Dutch native speakers. The Indonesian students pronounced the stressed vowels more clearly than their unstressed counterparts; yet their vowel diagram is smaller than the vowel diagram of the native speakers.

The Dutch private company: successfully relaunched?

NARCIS (Netherlands)

van der Elst, C.F.; Vermeulen, E.P.M.; De Cordt, Y.; Navez, E.J.

2014-01-01

This Chapter in a comparative book on private limited liability companies starts with an illustration of the former success of the Dutch limited liability company (BV). Next it addresses the competitive European legal environment within which the Dutch BV has to operate. The study shows how the

Improved Dutch Roll Approximation for Hypersonic Vehicle

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Liang-Liang Yin

2014-06-01

Full Text Available An improved dutch roll approximation for hypersonic vehicle is presented. From the new approximations, the dutch roll frequency is shown to be a function of the stability axis yaw stability and the dutch roll damping is mainly effected by the roll damping ratio. In additional, an important parameter called roll-to-yaw ratio is obtained to describe the dutch roll mode. Solution shows that large-roll-to-yaw ratio is the generate character of hypersonic vehicle, which results the large error for the practical approximation. Predictions from the literal approximations derived in this paper are compared with actual numerical values for s example hypersonic vehicle, results show the approximations work well and the error is below 10 %.

Quantifying the residual volume transport through a multiple-inlet system in response to wind forcing: The case of the western Dutch Wadden Sea

NARCIS (Netherlands)

Duran-Matute, M.; Gerkema, T.; Sassi, M.

2016-01-01

In multiple-inlet coastal systems like the western Dutch Wadden Sea, the tides (and their interaction with the bathymetry), the fresh water discharge, and the wind drive a residual flow through the system. In the current paper, we study the effect of the wind on the residual volume transport through

“Because It's an Islamic Marriage” Conditions Upon Marriage and after Divorce in Transnational Dutch-Moroccan and Dutch-Egyptian Marriages

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Iris Sportel

2013-12-01

Full Text Available Spouses in transnational Dutch-Moroccan or Dutch-Egyptian marriages potentially get married in a foreign legal system or in two legal systems with significant differences in, for example, marital property law. One of the ways to deal with the legal uncertainties of this situation is to include certain conditions in the marriage contract or a prenuptial agreement. This paper describes the experiences of spouses in Dutch-Moroccan and Dutch-Egyptian marriages with marital agreements at marriage and after divorce. I will go into the legal specifics and complications of marriage contracts and prenuptial agreements in a transnational context and to the meaning of these arrangements for the participants in the research. I will divide the different sorts of agreements at marriage into different categories and analyse why some couples choose to include conditions while others do not. Los cónyuges de matrimonios transnacionales holandeses-marroquíes y holandeses-egipcios potencialmente se casan en un sistema jurídico extranjero o en dos sistemas legales con diferencias significativas con respecto a, por ejemplo, la ley de propiedad conyugal y la regulación del divorcio. Una de las maneras de hacer frente a los riesgos percibidos y las incertidumbres jurídicas de esta situación es incluir las condiciones en el contrato de matrimonio o en un acuerdo prenupcial. Este artículo describe las experiencias de los cónyuges en matrimonios holandeses-marroquíes y holandeses-egipcios con acuerdos sobre el matrimonio y después del divorcio. La autora se refiere a los detalles legales y las complicaciones de los contratos matrimoniales y acuerdos prenupciales en un contexto transnacional y el significado de estas disposiciones para los participantes en la investigación, analizando por qué algunas parejas tienen una visión contractual del matrimonio, mientras que otras no la tienen.

The Dutch Experience with Weighted Student Funding

Science.gov (United States)

Fiske, Edward B.; Ladd, Helen F.

2010-01-01

Weighted student funding (WSF) is used in several U.S. cities as a method for providing more funds to schools with high concentrations of disadvantaged students. The practice has been used successfully in the Netherlands since 1985. Several factors make the success of the Dutch system unlikely to transfer to the United States, including the Dutch…

Morbidity And Mortality Following Emergency Obstetric ...

African Journals Online (AJOL)

Morbidity And Mortality Following Emergency Obstetric Hysterectomy In Calabar, Nigeria. ... Nigerian Journal of Clinical Practice ... in 15 (33.3%) of the case and hysterectomy for puerperal sepsis was an indication in 3 (6.7%) of the cases

Does Uterine Fibroid Adversely Affect Obstetric Outcome of Pregnancy?

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Hend S. Saleh

2018-01-01

Full Text Available Background. Fibroid is the most common benign tumor of the uterus and if associated with pregnancy may adversely affect the outcome of pregnancy. Objective of the present study was to assess the obstetric outcome (maternal and fetal in pregnancy with fibroid. Methods. A prospective observational study was performed over a period from May 2015 to August 2017 at Obstetrics and Gynecology Department in Zagazig University Hospitals, Egypt. 64 pregnant patients with >2 cm fibroid were taken in the study. Routine fundamental investigations were done for all. They were followed during antenatal period clinically and scanned by ultrasonogram which was done at booking visit and during subsequent visits to assess the change in the size of the fibroid and other obstetric complications. Maternal age, parity, size of fibroid, complications during pregnancy, and mode of delivery were noted. Results. 64 pregnant patients with uterine fibroids were recruited; 47 of them completed the study to the end. The average age was 31.80±3.27 years, body mass index (BMI [calculated as weight in kilograms divided by the square of height in meters] was 24.67±2.46, primigravida was 23.4%, multigravida was 76.6%, duration of menstrual cycle/day was 29.68±3.10, and duration of menstrual period/day was 6.46±1.12. The percentage of spontaneous conception was 59.57% and 40.43% for using assisted reproductive technology. The results of obstetric outcome were spontaneous abortion in 2%, premature delivery in 27.7%, and delivery at 37–41 weeks of pregnancy in 70.2%. The mode of delivery was vaginal delivery in 15% and cesarean sections in 85%. Also, 34% had threatened miscarriage, 21% had preterm labor, 2% had antepartum bleeding in the form of placenta previa, 4% had abdominal pain needing admission, one of them underwent laparotomy and was diagnosed as red degeneration, 2 (4% had postpartum hemorrhage, and only one needed blood transfusion. Cesarean sections were done in

Exporting climate change and environmental degradation. How Dutch public money is used to finance the oil industry

International Nuclear Information System (INIS)

Hamilton, J.; Stockman, L.; Muttitt, G.; Horta, K.; Kochladze, M.; Lisitsyn, D.; Barannikova, N.

2005-06-01

According to this report Dutch public money is being used to support oil production in developing countries through Multilateral Development Banks (MDBs) such as the World Bank and European Bank for Reconstruction and Development (EBRD), and other International Financial Institutions (IFIs) such as Atradius (the Dutch Export Credit Agency) and the European Investment Bank (EIB). The Dutch government contributes to MDBs in two ways: through financial contributions using public money and by voting on the boards of the banks. This report demonstrates the need for far greater parliamentary oversight over the Dutch role in MDBs to keep the use of Dutch public money in line with Dutch government policy. Three case studies illustrate that recent oil projects financed and supported by MDBs and other Dutch government departments are failing the poor and undermining national and international targets on development and climate change: the Cameroon Pipeline in West Africa; the Baku-T'bilisi-Ceyhan pipeline system in the South Caucasus and the Sakhalin-II Oil and Gas Project in far eastern Russia.

Workplace System Factors of Obstetric Nurses in Northeastern Ontario, Canada: Using a Work Disability Prevention Approach

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Behdin Nowrouzi

2015-12-01

Conclusion: Work ability is closely related to job and career satisfaction, and perceived control at work among obstetric nursing. In order to improve work ability, nurses need to work in environments that support them and allow them to be engaged in the decision-making processes.

Management of the Dutch development cooperation

NARCIS (Netherlands)

Janssen, Lodevicus Johannes Henricus

2009-01-01

There is reason for concern about the Dutch development cooperation. A survey of some aid evaluations of the Dutch Ministry of Foreign Affairs (MFA) showed that the aid results are limited and that the goals of the programs are not achieved. Management concerns using an organisation's resources to

A Violent Birth: Reframing Coerced Procedures During Childbirth as Obstetric Violence.

Science.gov (United States)

Borges, Maria TR

2018-01-01

In the United States, women are routinely forced to undergo cesarean sections, episiotomies, and the use of forceps, despite their desire to attempt natural vaginal delivery. Yet, the current American legal system does little to provide redress for women coerced to undergo certain medical procedures during childbirth. Courts and physicians alike are prepared to override a woman's choice of childbirth procedure if they believe this choice poses risks to the fetus, and both give little value to the woman's right to bodily autonomy. This Note proposes a solution for addressing the problem of coerced medical procedures during childbirth by importing a framework created in Venezuela and Argentina that characterizes this issue as "obstetric violence." First, this Note contains an overview of the shortcomings of the existing American legal framework to address the problem. Second, it explains the advantages of the obstetric violence framework and argues that its adoption in the United States would address many of the failures of the existing system. And third, this Note introduces a few legislative and litigation strategies that can be used to implement this framework in the United States and briefly addresses some of the challenges these strategies may pose.

Similar associations between personality dimensions and anxiety or depressive disorders in a population study of Turkish-Dutch, Moroccan-Dutch, and native Dutch subjects.

Science.gov (United States)

Schrier, Agnes C; de Wit, Matty A S; Krol, Anneke; Fassaert, Thijs J L; Verhoeff, Arnoud P; Kupka, Ralph W; Dekker, Jack; Beekman, Aartjan T F

2013-05-01

It is well established that personality traits are associated with anxiety and depressive disorders in Western populations, but it is not known whether this is true also for people from non-Western cultures. In this study, we examined whether ethnicity moderates the association between personality dimensions and anxiety or depressive disorders or symptoms. In a random urban population sample, stratified by ethnicity, in Amsterdam, the Netherlands, we interviewed 309 native Dutch subjects, 203 Turkish-Dutch subjects, and 170 Moroccan-Dutch subjects. Dimensions of personality were measured using the NEO Five-Factor Inventory. Anxiety and depressive disorders and symptom levels were assessed with the Composite International Diagnostic Interview and the Symptom Checklist-90-Revised. The association between personality factors and disorders or symptoms of anxiety and depression was very similar in the three ethnic groups: all show the typical profile of high neuroticism and low extraversion, agreeableness, and conscientiousness.

Impact of surgery on quality of life of women with obstetrical fistula: a qualitative study in Burkina Faso.

Science.gov (United States)

Désalliers, Julie; Paré, Marie-Eve; Kouraogo, Salam; Corcos, Jacques

2017-07-01

Obstetric fistula, caused by traumatic delivery and patient lack of access to obstetric care, is an important public health concern in developing countries, particularly in Sub-Saharan Africa. This research focuses on the experience of women living with obstetric fistula in Burkina Faso as well as their reintegration into community after surgery. This project was funded by the Mères du Monde en Santé (MMS) Foundation and conducted in collaboration with the Boromo Hospital. A qualitative approach based on grounded theory and using the principles of participative action research (PAR) was used with semidirected interviews prior to surgery and follow-up interviews 1-2 years after surgery directly in the women's village of origin. Thirty-nine participants were recruited between 2012 and 2015. The results point to circumstances leading to obstetric fistula development: poverty, gender inequality in terms of decision making, healthcare-system deficiencies, and lack of services for referral and treatment of this condition. Our results reinforce the knowledge about the social and psychological repercussions of fistula by exploring the concepts of gossips, shame and self-exclusion as powerful mechanisms of exclusion, but they also show that social support was conserved for several women through their journey with this disease. There was complete social rehabilitation within the community after surgery; however, persistent barriers in term of anxiety regarding obstetric future and economic insecurity were present. Early recruitment for surgery and prevention are the main objectives when attempting to reduce the impact of obstetric fistula and facilitate patient reintegration. Improvements in local and governmental public health policies are required.

The Dutch Health Care Performance Report: seven years of health care performance assessment in the Netherlands

NARCIS (Netherlands)

van den Berg, Michael J.; Kringos, Dionne S.; Marks, Lisanne K.; Klazinga, Niek S.

2014-01-01

In 2006, the first edition of a monitoring tool for the performance of the Dutch health care system was released: the Dutch Health Care Performance Report (DHCPR). The Netherlands was among the first countries in the world developing such a comprehensive tool for reporting performance on quality,

Dutch radiodiagnostics viewed internationally

International Nuclear Information System (INIS)

Valois, J.C. de

1990-01-01

Dutch radiodiagnostics viewed internationally. - A quantitative description of diagnostic radiology is given in terms of radiological density (the number of radiological examinations per 1000 inhibitants), consumptions of roentgen film and contrast media. The data concerning examinations were recorded by a yearly inquiry system addressing all Dutch radiologists. The consumption of film and contrast media were derived from the data banks of the industries. In comparing these data with the data for Western Europe, Japan and the United States it is remarkable that diagnostic radiology scores lowest in regard to density, film consumption and use of contrast media. Only in the use of 35 mm cinefilm (coronary angiography) is The Netherlands number 2 on the list preceded by the United States. As a consequence radiation exposure of the population caused by diagnostic radiology is low in The Netherlands. Although the technical condition of the equipment is good due to regular and preventive service the life-span of the radiological equipment is gradually increasing beyond the limits of the normal economic depreciation. Growing arrears are found in the application of new technology: ultrasound, computer tomography and magnetic resonance imaging. The substitution of high osmolar contrast media by low osmolar media is also laggin gbehind. (author). 10 refs.; 1 fig.; 4 tab

Eumedion in the Dutch Corporate Governance and Sustainability Landscape

NARCIS (Netherlands)

Hermes, Niels; Hooghiemstra, Reggy; van Veen, Kees

2016-01-01

Eumedion is a Dutch foundation representing the interests of Dutch and foreign institutional investors with investments in Dutch listed companies. In particular, it represents the interests of these participants in the field of corporate governance and sustainability. The foundation was established

Obstetric medicine

Directory of Open Access Journals (Sweden)

L. Balbi

2013-05-01

Full Text Available BACKGROUND Obstetric assistance made major advances in the last 20 years: improved surgical technique allows quicker caesarean sections, anaesthesiology procedures such as peripheral anaesthesia and epidural analgesia made safer operative assistance, remarkably reducing perioperative morbidity and mortality, neonatology greatly improved the results of assistance to low birth weight newborns. A new branch of medicine called “obstetric medicine” gained interest and experience after the lessons of distinguished physicians like Michael De Swiet in England. All together these advances are making successful pregnancies that 20 years ago would have been discouraged or even interrupted: that’s what we call high risk pregnancy. High risk of what? Either complications of pregnancy on pre-existing disease or complications of pre-existing disease on pregnancy. Nowadays, mortality in pregnancy has a medical cause in 80% of cases in Western countries (Confidential Enquiry on Maternal Deaths, UK, 2004. DISCUSSION The background is always changing and we have to take in account of: increase of maternal age; widespread use of assisted fertilization techniques for treatment of infertility; social feelings about maternity desire with increasing expectations from medical assistance; immigration of medically “naive” patients who don’t know to have a chronic disease, but apt and ready to conceive; limited knowledge of feasibility of drug use in pregnancy which may induce both patients and doctors to stopping appropriate drug therapy in condition of severe disease. Preconception counseling, planning the pregnancy, wise use of drugs, regular follow-up throughout the pregnancy and, in selected cases, preterm elective termination of pregnancy may result in excellent outcome both for mother and foetus. CONCLUSIONS Highly committed and specifically trained physicians are required to counsel these patients and to plan their treatment before and during pregnancy.

Dutch euthanasia revisited.

Science.gov (United States)

Fenigsen, R

1997-01-01

The results of a follow-up study of euthanasia by the Dutch government, five years after the first study, were published on November 26, 1996. This article provides a detailed review of the two reports comparing and contrasting the statistics cited therein. The author notes that the "rules of careful conduct" proposed by the courts and by the Royal Dutch Society of Medicine were frequently disregarded. Special topics included for the first time in the second study were the notification and non-prosecution procedure, euthanasia of newborns and infants, and assisted suicide in psychiatric practice. The authors of the follow-up report state that it would be desirable to reduce the number of "terminations of life without patients' request," but this must be the common responsibility of the doctor and the patient. They suggest that the person who does not wish to have his life terminated should declare this clearly, in advance, verbally and in writing, preferably in the form of a living will. Involuntary euthanasia was rampant in 1990 and equally rampant in 1995. The author concludes that Dutch doctors who practice euthanasia are not on the slippery slope. From the very beginning, they have been at the bottom.

Does Experience Rating Improve Obstetric Practices?

DEFF Research Database (Denmark)

Amaral-Garcia, Sofia; Bertoli, Paola; Grembi, Veronica

2015-01-01

is associated with a decrease in the probability of performing a C-section from 2.3 to 3.7 percentage points (7–11.6%) with no consequences for medical complications or neonatal outcomes. The impact can be explained by a reduction in the discretion of obstetric decision-making rather than by patient cream......Using inpatient discharge records from the Italian region of Piedmont, we estimate the impact of an increase in malpractice pressure brought about by experience-rated liability insurance on obstetric practices. Our identification strategy exploits the exogenous location of public hospitals in court...... districts with and without schedules for noneconomic damages. We perform difference-in-differences analysis on the entire sample and on a subsample which only considers the nearest hospitals in the neighborhood of court district boundaries. We find that the increase in medical malpractice pressure...

Obstetrical complications of endometriosis, particularly deep endometriosis.

Science.gov (United States)

Leone Roberti Maggiore, Umberto; Inversetti, Annalisa; Schimberni, Matteo; Viganò, Paola; Giorgione, Veronica; Candiani, Massimo

2017-12-01

Over the past few years, a new topic in the field of endometriosis has emerged: the potential impact of the disease on pregnancy outcomes. This review aims to summarize in detail the available evidence on the relationship between endometriosis, particularly deep endometriosis (DE), and obstetrical outcomes. Acute complications of DE, such as spontaneous hemoperitoneum, bowel perforation, and uterine rupture, may occur during pregnancy. Although these events represent life-threatening conditions, they are rare and unpredictable. Therefore, the current literature does not support any kind of prophylactic surgery before pregnancy to prevent such complications. Results on the impact of DE on obstetrical outcomes are debatable and characterized by several limitations, including small sample size, lack of adjustment for confounders, lack of adequate control subjects, and other methodologic flaws. For these reasons, it is not possible to draw conclusions on this topic. The strongest evidence shows that DE is associated with higher rates of placenta previa; for other obstetrical outcomes, such as miscarriage, intrauterine growth restriction, preterm birth and hypertensive disorders, results are controversial. Although it is unlikely that surgery of DE may modify the impact of the disease on the course of pregnancy, no study has yet investigated this issue. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The Dutch National Research Agenda in Perspective

OpenAIRE

2017-01-01

The Dutch National Research Agenda is a set of national priorities that are set by scientists working in conjunction with corporations, civil society organisations, and interested citizens. The agenda consolidates the questions that scientific research will be focused on in the coming year. This book covers the current status of the Dutch National Research Agenda and considers what changes and adjustments may need to be made to the process in order to keep Dutch national research at the top o...

Capturing early signs of deterioration: the dutch-early-nurse-worry-indicator-score and its value in the Rapid Response System.

Science.gov (United States)

Douw, Gooske; Huisman-de Waal, Getty; van Zanten, Arthur R H; van der Hoeven, Johannes G; Schoonhoven, Lisette

2017-09-01

To determine the predictive value of individual and combined dutch-early-nurse-worry-indicator-score indicators at various Early Warning Score levels, differentiating between Early Warning Scores reaching the trigger threshold to call a rapid response team and Early Warning Score levels not reaching this point. Dutch-early-nurse-worry-indicator-score comprises nine indicators underlying nurses' 'worry' about a patient's condition. All indicators independently show significant association with unplanned intensive care/high dependency unit admission or unexpected mortality. Prediction of this outcome improved by adding the dutch-early-nurse-worry-indicator-score indicators to an Early Warning Score based on vital signs. An observational cohort study was conducted on three surgical wards in a tertiary university-affiliated teaching hospital. Included were surgical, native-speaking, adult patients. Nurses scored presence of 'worry' and/or dutch-early-nurse-worry-indicator-score indicators every shift or when worried. Vital signs were measured according to the prevailing protocol. Unplanned intensive care/high dependency unit admission or unexpected mortality was the composite endpoint. Percentages of 'worry' and dutch-early-nurse-worry-indicator-score indicators were calculated at various Early Warning Score levels in control and event groups. Entering all dutch-early-nurse-worry-indicator-score indicators in a multiple logistic regression analysis, we calculated a weighted score and calculated sensitivity, specificity, positive predicted value and negative predicted value for each possible total score. In 3522 patients, 102 (2·9%) had an unplanned intensive care/high dependency unit admissions (n = 97) or unexpected mortality (n = 5). Patients with such events and only slightly changed vital signs had significantly higher percentages of 'worry' and dutch-early-nurse-worry-indicator-score indicators expressed than patients in the control group. Increasing number

Complications of gynecologic and obstetric management

International Nuclear Information System (INIS)

Newton, M.; Newton, E.R.

1987-01-01

This book examines the incidence, diagnosis and management of complications associated with interventions used in gynecology and obstetrics. These are encountered in all phases of gynecologic and therapeutic procedures, radiation therapy, drug therapy and pre- and post-treatment care

Fourth Dutch Process Security Control Event

NARCIS (Netherlands)

Luiijf, H.A.M.; Zielstra, A.

2010-01-01

On December 1st, 2009, the fourth Dutch Process Control Security Event took place in Baarn, The Netherlands. The security event with the title ‘Manage IT!’ was organised by the Dutch National Infrastructure against Cybercrime (NICC). Mid of November, a group of over thirty people participated in the

Losses on Dutch residential mortgage insurances

NARCIS (Netherlands)

Francke, M.K.; Schilder, F.P.W.

2014-01-01

Purpose - This paper aims to study the data on losses on mortgage insurance in the Dutch housing market to find the key drivers of the probability of loss. In 2013, 25 per cent of all Dutch homeowners were "under water": selling the property will not cover the outstanding mortgage debt. The

Obstetric X-rays

International Nuclear Information System (INIS)

Mwachi, M.K.

2006-01-01

Radiography of the pelvis should never be taken to diagnose early pregnancy, because of potential hazards of radiation damage to the growing foetus. the only indication occurs in the last week of pregnancy (37 weeks). Obstetric X-ray will help you answer like confirmation of malposition,multiple pregnancies; fetal abnormalities e.g. hydrocephalus, foetal disposition. The choice of radiographic projection will help give foetal presentation, disposition as well as foetal maturity. The search pattern helps you determine maternal and spine deformity, foetal spine and head , foetal presentation and any other anomalies

Moral implications of obstetric technologies for pregnancy and motherhood.

Science.gov (United States)

Brauer, Susanne

2016-03-01

Drawing on sociological and anthropological studies, the aim of this article is to reconstruct how obstetric technologies contribute to a moral conception of pregnancy and motherhood, and to evaluate that conception from a normative point of view. Obstetrics and midwifery, so the assumption, are value-laden, value-producing and value-reproducing practices, values that shape the social perception of what it means to be a "good" pregnant woman and to be a "good" (future) mother. Activities in the medical field of reproduction contribute to "kinning", that is the making of particular social relationships marked by closeness and special moral obligations. Three technologies, which belong to standard procedures in prenatal care in postmodern societies, are presently investigated: (1) informed consent in prenatal care, (2) obstetric sonogram, and (3) birth plan. Their widespread application is supposed to serve the moral (and legal) goal of effecting patient autonomy (and patient right). A reconstruction of the actual moral implications of these technologies, however, reveals that this goal is missed in multiple ways. Informed consent situations are marked by involuntariness and blindness to social dimensions of decision-making; obstetric sonograms construct moral subjectivity and agency in a way that attribute inconsistent and unreasonable moral responsibilities to the pregnant woman; and birth plans obscure the need for a healthcare environment that reflects a shared-decision-making model, rather than a rational-choice-framework.

Teaching veterinary obstetrics using three-dimensional animation technology.

Science.gov (United States)

Scherzer, Jakob; Buchanan, M Flint; Moore, James N; White, Susan L

2010-01-01

In this three-year study, test scores for students taught veterinary obstetrics in a classroom setting with either traditional media (photographs, text, and two-dimensional graphical presentations) were compared with those for students taught by incorporating three-dimensional (3D) media (linear animations and interactive QuickTime Virtual Reality models) into the classroom lectures. Incorporation of the 3D animations and interactive models significantly increased students' scores on essay questions designed to assess their comprehension of the subject matter. This approach to education may help to better prepare students for dealing with obstetrical cases during their final clinical year and after graduation.

Obstetric care: competition or co-operation.

NARCIS (Netherlands)

Veer, A.J.E. de; Meijer, W.J.

1996-01-01

OBJECTIVE: The aim of this study was to determine the feasibility of co-operation within maternity and obstetric care between midwives, general practitioners (GPs) and obstetricians. DESIGN: descriptive correlational study. SETTING: The Netherlands. Policy is towards more co-operation between

Electricity in flux : sociotechnical change in the Dutch electricity system, 1970-2000

NARCIS (Netherlands)

Hofman, Peter; Marquart, N.E.

2001-01-01

This report is part of a project funded by the Dutch National Research Programme on Global Air Pollution and Climate Change (NRP) called MATRIC: Management of Technology Responses to the Climate Challenge. Central to the Matric project is the question "How to modulate the ongoing dynamics of

The Dutch are in the Self Quantification game

NARCIS (Netherlands)

Mariia Stolyga; Dr. Martijn de Groot

2015-01-01

The Quantified Self Institute (QSI) in Groningen is keeping a close eye on the global self-tracking culture to identify and assess major trends in this domain. How will the future of wearable tech look? Can self-tracking change the Dutch healthcare system? Dr. Martijn de Groot, a medical biologist

Validity of a hospital-based obstetric register using medical records as reference

DEFF Research Database (Denmark)

Brixval, Carina Sjöberg; Thygesen, Lau Caspar; Johansen, Nanna Roed

2015-01-01

BACKGROUND: Data from hospital-based registers and medical records offer valuable sources of information for clinical and epidemiological research purposes. However, conducting high-quality epidemiological research requires valid and complete data sources. OBJECTIVE: To assess completeness...... and validity of a hospital-based clinical register - the Obstetric Database - using a national register and medical records as references. METHODS: We assessed completeness of a hospital-based clinical register - the Obstetric Database - by linking data from all women registered in the Obstetric Database...... Database therefore offers a valuable source for examining clinical, administrative, and research questions....

Obstetrical complications in people at risk for developing schizophrenia

OpenAIRE

Ballon, Jacob S; Seeber, Katherine; Cadenhead, Kristin S

2007-01-01

Many factors have been associated with the development of schizophrenia, yet few studies have looked at these same factors in individuals considered at risk for schizophrenia, but who have not yet reached diagnostic threshold. The rate of obstetrical complications was assessed as part of a comprehensive battery in subjects at risk (N=52), or in the first episode of schizophrenia (N=18), and in normal comparison subjects (N=43). The rate of obstetrical complications was increased in the at ris...

Obstetric referrals from a rural clinic to a community hospital in Honduras.

Science.gov (United States)

Josyula, Srirama; Taylor, Kathryn K; Murphy, Blair M; Rodas, Dairamise; Kamath-Rayne, Beena D

2015-11-01

referrals between health care facilities are important in low-resource settings, particularly in maternal and child health, to transfer pregnant patients to the appropriate level of obstetric care. Our aim was to characterise the obstetrical referrals from a rural clinic to a community referral hospital in Honduras, to identify barriers in effective transport/referral, and to describe subsequent patient outcomes. we performed a descriptive retrospective study of patients referred during a 9-month period. We reviewed patient charts to review diagnosis, referral, and treatment times at both sites to understand the continuity of care. ninety-two pregnant patients were referred from the rural clinic to the community hospital. Twenty six pregnant patients (28%) did not have complete and accurate medical records and were excluded from the study. The remaining 66 patients were our study population. Of the 66 patients, 54 (82%) received antenatal care with an average of 5.5±2.4 visits. The most common diagnoses requiring referral were non-reassuring fetal status, hypertensive disorders of pregnancy, and preterm labour. The time spent in the rural clinic until transfer was 7.35±8.60 hours, and transport times were 4.42±1.07 hours. Of the 66 women transferred, 24 (36%) had different primary diagnoses and 16 (24%) had additional diagnoses after evaluation in the community hospital, whereas the remaining 26 (40%) had diagnoses that remained the same. No system was in place to give feedback to the referring clinic doctors regarding their primary diagnoses. our results demonstrate challenges seen in obstetric transport from a rural clinic to a community hospital in Honduras. Further research is needed for reform of emergency obstetric care management, targeting both healthcare personnel and medical referral infrastructure. The example of Honduras can be taken to motivate change in other resource-limited areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

Teaching the Dutch how to pronounce English

NARCIS (Netherlands)

Frans Hermans; Peter Sloep

2015-01-01

The Dutch overestimate their English speaking skills. Their pronunciation is not always convincing and certain pronunciation mistakes are easily recognised as being typical for Dutch speakers of English. Although intelligibility cannot exist without adequate pronunciation, teaching English

Teaching the Dutch how to pronounce English

NARCIS (Netherlands)

Hermans, Frans; Sloep, Peter

2018-01-01

The Dutch overestimate their English speaking skills. Their pronunciation is not always convincing, and certain pronunciation mistakes are easily recognised as being typical for Dutch speakers of English. Although intelligibility cannot exist without adequate pronunciation, teaching English

Obstetric patients' health-related quality of life before and after intensive care.

Science.gov (United States)

Pia, Seppänen; Reijo, Sund; Tero, Ala-Kokko; Mervi, Roos; Jukka, Uotila; Mika, Helminen; Tarja, Suominen

2018-03-23

Intensive care admissions during pregnancy, childbirth, and postpartum period are relatively well investigated. However, very little is known about these obstetric patients' health-related quality of life (HRQoL) before and after critical care. The objective of this study was to assess obstetric patients' HRQoL before intensive care admission (baseline) and at 6 months after discharge (follow-up) DESIGN: This was a retrospective database study. In a 5-year period, the data of all women admitted to the intensive care unit (ICU) during pregnancy, delivery, or up to 42 days postpartum were analysed. Four multidisciplinary ICUs of Finnish University hospitals participated. The HRQoL was assessed using the EuroQol-5D (EQ-5D) instrument with utility score (EQsum) and visual analogue scale (EQ-VAS). A total of 283 obstetric patients were identified from the clinical information system. Of these, 99 (35%) completed the EQ-5D questionnaires both at baseline and follow-up, and 65 of them (23%) completed EQ-VAS. The comparison of patients' EQsum scores before intensive care admission and after discharge showed that patients' HRQoL remained good (0.970 vs 0.972) (max 1.0) or increased (0.788 vs 0.982) in 80.8% of the patients. Patients reported improved overall health on the EQ-VAS at 6 months follow-up (EQ-VAS mean, 71.86 vs 88.20; p ≤ 0.001) (max 100). However, 19.2% of the patients had lower HRQoL (EQsum mean 0.987 vs 0.798) at follow-up. Following intensive care, 15% of the patients had more pain/discomfort, and 11% expressed more depression/anxiety. Multiparous patients were more likely to suffer from worsened depression/anxiety (p = 0.024). In the majority of the obstetric patients, HRQoL at 6 months follow-up remained good or had increased from baseline. However, nearly one-fifth of the patients had impaired HRQoL after discharge. Thus, intensive care management should take in to consideration follow-up program after intensive care of ICU-admitted obstetric

A case-control study of the risk factors for obstetric fistula in Tigray, Ethiopia.

Science.gov (United States)

Lewis Wall, L; Belay, Shewaye; Haregot, Tesfahun; Dukes, Jonathan; Berhan, Eyoel; Abreha, Melaku

2017-12-01

We tested the null hypothesis that there were no differences between patients with obstetric fistula and parous controls without fistula. A unmatched case-control study was carried out comparing 75 women with a history of obstetric fistula with 150 parous controls with no history of fistula. Height and weight were measured for each participant, along with basic socio-demographic and obstetric information. Descriptive statistics were calculated and differences between the groups were analyzed using Student's t test, Mann-Whitney U test where appropriate, and Chi-squared or Fisher's exact test, along with backward stepwise logistic regression analyses to detect predictors of obstetric fistula. Associations with a p value divorce/separation, and lived in more impoverished circumstances than controls. Fistula patients had worse reproductive histories, with greater numbers of stillbirths/abortions and higher rates of assisted vaginal delivery and cesarean section. The final logistic regression model found four significant risk factors for developing an obstetric fistula: age at marriage (OR 1.23), history of assisted vaginal delivery (OR 3.44), lack of adequate antenatal care (OR 4.43), and a labor lasting longer than 1 day (OR 14.84). Our data indicate that obstetric fistula results from the lack of access to effective obstetrical services when labor is prolonged. Rural poverty and lack of adequate transportation infrastructure are probably important co-factors in inhibiting access to needed care.

Does Media Use Result in More Active Communicators? Differences Between Native Dutch and Turkish-Dutch Patients in Information-Seeking Behavior and Participation During Consultations With General Practitioners.

Science.gov (United States)

Schinkel, Sanne; Van Weert, Julia C M; Kester, Jorrit A M; Smit, Edith G; Schouten, Barbara C

2015-08-01

This study investigates differences between native Dutch and Turkish-Dutch patients with respect to media usage before and patient participation during medical consultations with general practitioners. In addition, the authors assessed the relation between patient participation and communication outcomes. The patients were recruited in the waiting rooms of general practitioners, and 191 patients (117 native Dutch, 74 Turkish-Dutch) completed pre- and postconsultation questionnaires. Of this sample, 120 patients (62.8%; 82 native Dutch, 38 Turkish-Dutch) agreed to have their consultations recorded to measure patient participation. Compared with Turkish-Dutch patients of similar educational levels, results showed that native Dutch patients used different media to search for information, participated to a greater extent during their consultations and were more responsive to their general practitioner. With respect to the Turkish-Dutch patients, media usage was related to increased patient participation, which was correlated with having fewer unfulfilled information needs; however, these relations were not found in the native Dutch patient sample. In conclusion, interventions that enhance participation among ethnic minority patients will better fulfill informational needs when such interventions stimulate information-seeking behavior in that group before a medical consultation.

Between local governments and communities : Knowledge exchange and mutual learning in Dutch-Moroccan and Dutch-Turkish municipal partnerships

NARCIS (Netherlands)

van Ewijk, E.

2013-01-01

This PhD dissertation focuses on mutual learning processes of governmental and non-governmental actors involved in Dutch-Moroccan and Dutch-Turkish municipal partnerships in the period 2007-2011. These partnerships aim at strengthening local governance in Morocco and Turkey as well as in the

Compliance with the CONSORT checklist in obstetric anaesthesia randomised controlled trials.

Science.gov (United States)

Halpern, S H; Darani, R; Douglas, M J; Wight, W; Yee, J

2004-10-01

The Consolidated Standards for Reporting of Trials (CONSORT) checklist is an evidence-based approach to help improve the quality of reporting randomised controlled trials. The purpose of this study was to determine how closely randomised controlled trials in obstetric anaesthesia adhere to the CONSORT checklist. We retrieved all randomised controlled trials pertaining to the practice of obstetric anaesthesia and summarised in Obstetric Anesthesia Digest between March 2001 and December 2002 and compared the quality of reporting to the CONSORT checklist. The median number of correctly described CONSORT items was 65% (range 36% to 100%). Information pertaining to randomisation, blinding of the assessors, sample size calculation, reliability of measurements and reporting of the analysis were often omitted. It is difficult to determine the value and quality of many obstetric anaesthesia clinical trials because journal editors do not insist that this important information is made available to readers. Both clinicians and clinical researchers would benefit from uniform reporting of randomised trials in a manner that allows rapid data retrieval and easy assessment for relevance and quality.

Obstetric characteristics of two Mayan populations in the highlands of Guatemala.

Science.gov (United States)

Burket, Brent A

2017-10-01

The purpose of this study was to (1) describe and compare two obstetric Mayan populations in Guatemala, the Tz'utujil and the Kachiquel and (2) evaluate possible associations of demographics, wood fuel use, and obesity with pregnancy/newborn outcomes. This cross-sectional study interviewed participants at the time of routine obstetric ultrasounds at three institutions in Santiago Atitlán and one institution in San Lucas Tolimán. Data were collected from January 2010 to May 2013. Data entry and statistical analysis were performed using EPI Info TM 7.1.2.0 (CDC). The two populations were similar in maternal age, BMI, ownership of a phone, gravidity (number of times a women has been pregnant), history of spontaneous abortions, history of term pregnancies, newborn birth weights, cesarean section rate, and percentage of low-birth-weight newborns (LBW Guatemala. The obstetric characteristics, differences, and similarities between these two Mayan populations should help in policy planning for obstetric care for these two populations and possibly other indigenous populations in Guatemala.

The Strange Death of Dutch Tolerance: the Timing and Nature of the Pessimist Turn in the Dutch Migration Debate

NARCIS (Netherlands)

Lucassen, Leo; Lucassen, Jan

2015-01-01

In this article we explain why the Dutch nativist turn from the 1990s onwards was nourished both by the political left and the right and what the role was of specific Dutch developments in secularization and libertarian attitudes

Dutch taboo norms.

Science.gov (United States)

Roest, Sander A; Visser, Tessa A; Zeelenberg, René

2018-04-01

This article provides norms for general taboo, personal taboo, insult, valence, and arousal for 672 Dutch words, including 202 taboo words. Norms were collected using a 7-point Likert scale and based on ratings by psychology students from the Erasmus University Rotterdam in The Netherlands. The sample consisted of 87 psychology students (58 females, 29 males). We obtained high reliability based on split-half analyses. Our norms show high correlations with arousal and valence ratings collected by another Dutch word-norms study (Moors et al.,, Behavior Research Methods, 45, 169-177, 2013). Our results show that the previously found quadratic relation (i.e., U-shaped pattern) between valence and arousal also holds when only taboo words are considered. Additionally, words rated high on taboo tended to be rated low on valence, but some words related to sex rated high on both taboo and valence. Words that rated high on taboo rated high on insult, again with the exception of words related to sex many of which rated low on insult. Finally, words rated high on taboo and insult rated high on arousal. The Dutch Taboo Norms (DTN) database is a useful tool for researchers interested in the effects of taboo words on cognitive processing. The data associated with this paper can be accessed via the Open Science Framework ( https://osf.io/vk782/ ).

Interpreting The Chinese Wall knowing Dutch and ‘Dutchness'

NARCIS (Netherlands)

Forceville, C.

2015-01-01

Many film scholars equate "film" with "moving images." But, along with sound and music, language is often no less important for a film’s interpretation. This paper discusses how comprehension of the original Dutch affords subtle aspects of meaning unavailable to viewers who have to rely exclusively

Obstetric risks for women with epilepsy during pregnancy.

Science.gov (United States)

Kaplan, Peter W; Norwitz, Errol R; Ben-Menachem, Elinor; Pennell, Page B; Druzin, Maurice; Robinson, Julian N; Gordon, Jacki C

2007-11-01

Women with epilepsy (WWE) face particular challenges during their pregnancy. Among the several obstetric issues for which there is some concern and the need for further investigation are: the effects of seizures, epilepsy, and antiepileptic drugs on pregnancy outcome and, conversely, the effects of pregnancy and hormonal neurotransmitters on seizure control and antiepileptic drug metabolism. Obstetric concerns include preclampsia/eclampsia, preterm delivery, placental abruption, spontaneous abortion, stillbirth, and small-for-date babies in WWE whether or not they are taking antiepileptic drugs. The role of nutritional health elements, including body mass index, caloric and protein intake, vitamins and iron, and phytoestrogens, warrants further study. During the course of obstetric management, there is a need for a fuller understanding by neurologists of the risk-benefit calculations for various types and frequencies of fetal imaging, including CT, MRI, and ultrasound, as well as for the screening standards of care. As part of the Health Outcomes in Pregnancy and Epilepsy (HOPE) project, this expert panel provides a brief overview of these concerns, offers some approaches to management, and outlines potential areas for further investigation. More detailed information and guidelines are available elsewhere.

Brucellosis in pregnancy: clinical aspects and obstetric outcomes.

Science.gov (United States)

Vilchez, Gustavo; Espinoza, Miguel; D'Onadio, Guery; Saona, Pedro; Gotuzzo, Eduardo

2015-09-01

Brucellosis is a zoonosis with high morbidity in humans. This disease has gained interest recently due to its re-emergence and potential for weaponization. Pregnant women with this disease can develop severe complications. Its association with adverse obstetric outcomes is not clearly understood. The objective of this study was to describe the obstetric outcomes of brucellosis in pregnancy. Cases of pregnant women with active brucellosis seen at the Hospital Nacional Cayetano Heredia from 1970 to 2012 were reviewed. Diagnostic criteria were a positive agglutination test and/or positive blood/bone marrow culture. Presentation and outcomes data were collected. The Chi-square test was used for nominal variables. A p-value of brucellosis in 6.4%. The most common treatment was aminoglycosides plus rifampicin (42.2% of cases). Complication rates decreased if treatment was started within 2 weeks of presentation (p brucellosis in pregnancy reported in the literature. Brucella presents adverse obstetric outcomes including fetal and maternal/neonatal death. Cases with unexplained spontaneous abortion should be investigated for brucellosis. Prompt treatment is paramount to decrease the devastating outcomes. Copyright © 2015. Published by Elsevier Ltd.

Bio Psycho Social Obstetrics and Gynaecology

NARCIS (Netherlands)

Paarlberg, KM; van de Wiel, Henricus

2017-01-01

This book will assist the reader by providing individually tailored, high-quality bio-psycho-social care to patients with a wide range of problems within the fields of obstetrics, gynaecology, fertility, oncology, and sexology. Each chapter addresses a particular theme, issue, or situation in a

Qualitative comparison of Dutch and Ethiopian Rose production systems. Why Dutch rose growers move to African Nations and what consequences does this migration have?

NARCIS (Netherlands)

Vries de, Willem

2010-01-01

Summary The rose cultivation is used as a study example in this report to facilitate the understanding of the overall differences between the cultivation of agricultural products in the Netherlands and those in warmer countries. The Dutch rose cultivat

Lexical preferences in Dutch verbal cluster ordering

NARCIS (Netherlands)

Bloem, J.; Bellamy, K.; Karvovskaya, E.; Kohlberger, M.; Saad, G.

2016-01-01

This study discusses lexical preferences as a factor affecting the word order variation in Dutch verbal clusters. There are two grammatical word orders for Dutch two-verb clusters, with no clear meaning difference. Using the method of collostructional analysis, I find significant associations

Tropical Journal of Obstetrics and Gynaecology: Submissions

African Journals Online (AJOL)

... minimum printing cost of about 150 copies for authors and advertising organization ... Nonmembers: Please send change of address information to subscriptions@ ... The entire contents of the Tropical Journal of Obstetrics and Gynaecology ...

‘Essential but not always available when needed’ – an interview study of physicians’ experiences and views regarding use of obstetric ultrasound in Tanzania

Directory of Open Access Journals (Sweden)

Annika Åhman

2016-07-01

Full Text Available Background: The value of obstetric ultrasound in high-income countries has been extensively explored but evidence is still lacking regarding the role of obstetric ultrasound in low-income countries. Objective: We aimed to explore experiences and views among physicians working in obstetric care in Tanzania, on the role of obstetric ultrasound in relation to clinical management. Design: A qualitative study design was applied. Data were collected in 2015, through 16 individual interviews with physicians practicing in obstetric care at hospitals in an urban setting in Tanzania. Data were analyzed using qualitative content analysis. Results: Use of obstetric ultrasound in the management of complicated pregnancy was much appreciated by participating physicians, although they expressed considerable concern about the lack of ultrasound equipment and staff able to conduct the examinations. These limitations were recognized as restricting physicians’ ability to manage complications adequately during pregnancy and birth. Better availability of ultrasound was requested to improve obstetric management. Concerns were also raised regarding pregnant women's lack of knowledge and understanding of medical issues which could make counseling in relation to obstetric ultrasound difficult. Although the physicians perceived a positive attitude toward ultrasound among most pregnant women, occasionally they came across women who feared that ultrasound might harm the fetus. Conclusions: There seems to be a need to provide more physicians in antenatal care in Tanzania with ultrasound training to enable them to conduct obstetric ultrasound examinations and interpret the results themselves. Physicians also need to acquire adequate counseling skills as counseling can be especially challenging in this setting where many expectant parents have low levels of education. Providers of obstetric care and policy makers in Tanzania will need to take measures to ensure appropriate

Frequency and impact of obstetric complications prior and subsequent to unexplained secondary recurrent miscarriage

DEFF Research Database (Denmark)

Nielsen, H S; Steffensen, R; Lund, M

2010-01-01

The chance of a live birth after a diagnosis of secondary recurrent miscarriage (SRM) is reduced in patients who, prior to the miscarriages, gave birth to a boy and carry HLA class II alleles that efficiently present male-specific (H-Y) antigens to the immune system. Information about obstetric...

Exploring Normalized Systems Potential for Dutch MoD’s Agility : A Proof of Concept on Flexibility, Time-to-market, Productivity and Quality

NARCIS (Netherlands)

Op 't Land, M.; Krouwel, M.R.; Van Dipten, E.G.; Verelst, J.

2011-01-01

Both the Command and Control Support Centre (C2SC) of the Dutch Ministry of Defense, and Capgemini are constantly exploring better ways of building and maintaining information systems which ef- fectively support strategy and operations of an enterprise. In a Proof of Concept conducted in March and

Cross-Language Measurement Equivalence of the Center for Epidemiologic Studies Depression (CES-D) Scale in Systemic Sclerosis: A Comparison of Canadian and Dutch Patients

Science.gov (United States)

Kwakkenbos, Linda; Arthurs, Erin; van den Hoogen, Frank H. J.; Hudson, Marie; van Lankveld, Wim G. J. M.; Baron, Murray; van den Ende, Cornelia H. M.; Thombs, Brett D.

2013-01-01

Objectives Increasingly, medical research involves patients who complete outcomes in different languages. This occurs in countries with more than one common language, such as Canada (French/English) or the United States (Spanish/English), as well as in international multi-centre collaborations, which are utilized frequently in rare diseases such as systemic sclerosis (SSc). In order to pool or compare outcomes, instruments should be measurement equivalent (invariant) across cultural or linguistic groups. This study provides an example of how to assess cross-language measurement equivalence by comparing the Center for Epidemiologic Studies Depression (CES-D) scale between English-speaking Canadian and Dutch SSc patients. Methods The CES-D was completed by 922 English-speaking Canadian and 213 Dutch SSc patients. Confirmatory factor analysis (CFA) was used to assess the factor structure in both samples. The Multiple-Indicator Multiple-Cause (MIMIC) model was utilized to assess the amount of differential item functioning (DIF). Results A two-factor model (positive and negative affect) showed excellent fit in both samples. Statistically significant, but small-magnitude, DIF was found for 3 of 20 items on the CES-D. The English-speaking Canadian sample endorsed more feeling-related symptoms, whereas the Dutch sample endorsed more somatic/retarded activity symptoms. The overall estimate in depression scores between English and Dutch was not influenced substantively by DIF. Conclusions CES-D scores from English-speaking Canadian and Dutch SSc patients can be compared and pooled without concern that measurement differences may substantively influence results. The importance of assessing cross-language measurement equivalence in rheumatology studies prior to pooling outcomes obtained in different languages should be emphasized. PMID:23326538

Rewarding peak avoidance: the Dutch 'Spitsmijden' projects

NARCIS (Netherlands)

Knockaert, J.; Bakens, J.; Ettema, D.F.; Verhoef, E.

2011-01-01

The Dutch road network is becoming increasingly congested. In late 2006, a group of companies, universities and government institutions established the Spitsmijden project. ‘Spitsmijden’ is the Dutch term for ‘avoiding the peak’. This joint initiative aimed to identify and assess a short-term

Sustainable Entrepreneurship in the Dutch Construction Industry

NARCIS (Netherlands)

Klein Woolthuis, R.J.A.

2010-01-01

This article discusses the strategies that sustainable entrepreneurs use to interact with their environment in the Dutch construction industry. The Dutch construction industry is under great pressure to move towards sustainability, and entrepreneurs are believed to be able to play a large role in

Sustainable entrepreneurship in the Dutch construction industry

NARCIS (Netherlands)

Klein Woolthuis, R.J.A.

2010-01-01

This article discusses the strategies that sustainable entrepreneurs use to interact with their environment in the Dutch construction industry. The Dutch construction industry is under great pressure to move towards sustainability, and entrepreneurs are believed to be able to play a large role in

Nuclear medicine in obstetrics and gynecology

International Nuclear Information System (INIS)

Patterson, V.N.

1975-01-01

The role of radioisotopes for diagnosis and therapy in obstetrics and gynecology are reviewed. A brief history of the development of nuclear medicine is given along with a discussion of basic concepts. Finally a more detailed overview with graphs and pictures is presented for specific techniques

Freestanding midwifery unit versus obstetric unit

DEFF Research Database (Denmark)

Overgaard, Charlotte; Møller, Anna Margrethe; Fenger-Grøn, Morten

2011-01-01

low-risk women intending FMU birth and a matched control group of 839 low-risk women intending OU birth were included at the start of care in labour. OU women were individually chosen to match selected obstetric/socio-economic characteristics of FMU women. Analysis was by intention to treat. Main......Objective To compare perinatal and maternal morbidity and birth interventions in low-risk women giving birth in two freestanding midwifery units (FMUs) and two obstetric units (OUs). Design A cohort study with a matched control group. Setting The region of North Jutland, Denmark. Participants 839...... women were significantly less likely to experience an abnormal fetal heart rate (RR: 0.3, 95% CI 0.2 to 0.5), fetal–pelvic complications (0.2, 0.05 to 0.6), shoulder dystocia (0.3, 0.1 to 0.9), occipital–posterior presentation (0.5, 0.3 to 0.9) and postpartum haemorrhage >500 ml (0.4, 0.3 to 0...

The history of imaging in obstetrics.

Science.gov (United States)

Benson, Carol B; Doubilet, Peter M

2014-11-01

During the past century, imaging of the pregnant patient has been performed with radiography, scintigraphy, computed tomography, magnetic resonance imaging, and ultrasonography (US). US imaging has emerged as the primary imaging modality, because it provides real-time images at relatively low cost without the use of ionizing radiation. This review begins with a discussion of the history and current status of imaging modalities other than US for the pregnant patient. The discussion then turns to an in-depth description of how US technology advanced to become such a valuable diagnostic tool in the obstetric patient. Finally, the broad range of diagnostic uses of US in these patients is presented, including its uses for distinguishing an intrauterine pregnancy from a failed or ectopic pregnancy in the first trimester; assigning gestational age and assessing fetal weight; evaluating the fetus for anomalies and aneuploidy; examining the uterus, cervix, placenta, and amniotic fluid; and guiding obstetric interventional procedures.

Evaluating congestion management in the Dutch electricity transmission grid

International Nuclear Information System (INIS)

Blijswijk, Martti J. van; Vries, Laurens J. de

2012-01-01

Due to the increase in electricity generation capacity in the Netherlands and a new connection policy, transmission system operator (TSO) TenneT expects a significant increase in congestion in the Dutch transmission grid. To manage this, the Dutch government implemented redispatching, a method which is argued in the literature to potentially impose large congestion costs upon the TSO. A quantitative model of the Dutch electricity system was developed in order to evaluate this method. The outcomes were compared to the performance of three alternative congestion management methods. Regardless of the method, congestion costs were found to be substantially lower than in previous studies. Because combined-cycle gas turbines are the marginal generation technology in almost all cases, the costs of up and down regulation do not differ much. Consequently, the redispatching costs for the TSO are expected to be relatively low, and the opportunities for abuse of market power appear to be limited. While all the evaluated methods are effective and economically efficient, they have significantly different welfare effects. Market splitting creates significantly larger welfare effects than the different varieties of redispatching. - Highlights: ► Congestion management was recently introduced in the Netherlands. ► We quantitatively evaluate the effects of its application. ► We compare this to other congestion management methods. ► Given the specific situation that the marginal cost curve of production is flat, congestion costs are expected to be low.

knowledge about obstetric danger signs among preg

African Journals Online (AJOL)

user

about knowledge level of pregnant women on obstetric danger signs. The objective of this .... ple size formula for estimating a single population proportion with the ..... subjects mentioned vaginal bleeding as danger sign during pregnancy ...

Planning of and System for the Dutch National Cooperative Programme for Air Quality

International Nuclear Information System (INIS)

2006-06-01

In order to deal with the emission problem of particulates and NO2 in the Netherlands in the coming five year a new program to improve the air quality in the Netherlands will be set up and implemented (NSL, abbreviated in Dutch) [nl

Arousing Discontent : Dutch Pornographic Plays, 1670-1800

NARCIS (Netherlands)

Leemans, I.B.

2012-01-01

n the second half of the seventeenth century, the Dutch Republic became the "sex shop" of Europe, printing large varieties of erotic works and distributing them through various reader groups. The production of pornographic works also inspired Dutch authors, who developed new forms of erotic prose

Do individual characteristics matter? The quality of work during the implementation of a workflow management system in a Dutch social insurance company.

NARCIS (Netherlands)

Waal, B.M.E. de; Breman, P.; Batenburg, R.

2012-01-01

Do individual characteristics influence how the quality of work is related to the use of a workflow management system (WFM) in a Dutch social insurance organisation? This key question is addressed in this paper. Building upon DeLone and McLean’s model, we investigated the effects of gender, age,

Do individual characteristics matter? The quality of work during the implementation of a workflow management system in a Dutch social insurance company

NARCIS (Netherlands)

Dr. Paul Breman; Benny de Waal; Ronald Batenburg

2012-01-01

Do individual characteristics influence how the quality of work is related to the use of a workflow management system (WFM) in a Dutch social insurance organisation? This key question is addressed in this paper. Building upon DeLone and McLean’s model, we investigated the effects of gender, age,

Freestanding midwifery units versus obstetric units

DEFF Research Database (Denmark)

Overgaard, Charlotte; Fenger-Grøn, Morten; Sandall, Jane

2012-01-01

prospectively and individually matched on nine selected obstetric/socio-economic factors to 839 low-risk women intending OU birth. Educational level was chosen as a proxy for social position. Analysis was by intention-to-treat. Results Women intending to give birth in an FMU had a significantly higher...

Evaluation of multi-professional obstetric skills training for postpartum hemorrhage

DEFF Research Database (Denmark)

Markova, Veronika; Sørensen, Jette Led; Holm, Charlotte

2012-01-01

To evaluate the effect of multi-professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training.......To evaluate the effect of multi-professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training....

Obstetric critical care services in South Africa

African Journals Online (AJOL)

time of their first pregnancy, and assisted reproductive technology that has made it ... transport between levels of care, unavailability of blood and blood products ... 0.24%. Severe obstetric haemorrhage, hypertension and sepsis were the most ...

Obstetric and neonatal outcome after oocyte donation in 106 women with Turner syndrome

DEFF Research Database (Denmark)

Hagman, Anna; Loft, Anne; Wennerholm, Ulla-Britt

2013-01-01

What are the obstetric and neonatal outcomes of deliveries after oocyte donation (OD) in women with Turner syndrome (TS)?......What are the obstetric and neonatal outcomes of deliveries after oocyte donation (OD) in women with Turner syndrome (TS)?...

Obstetrical acute renal failure: a challenging medical complication

International Nuclear Information System (INIS)

Rizwan, N.

2011-01-01

Acute renal failure (ARF) is a syndrome characterised by rapid decline in glomerular filtration rate and retention of nitrogenous waste products such as urea and creatinine. The objective of this study was to study the prevalence, risk and outcome of women with obstetrical renal failure. Methods: This observational study was conducted in Department of Obstetrics and Gynaecology, Liaquat University Hospital, Hyderabad, Pakistan from October 2009 to September 2010. Thirty-five patients with obstetrical acute renal failure were included in the study, patients with chronic renal diseases, hypertension, diabetes mellitus and renal stones were excluded from the study. A detailed history was followed by thorough examination and investigation. Their clinical history, physical examination and intake/urine output was recorded. Routine laboratory investigations were done related to each case and specialised investigations like renal scan, renal ultrasonography and renal biopsies were performed in selected cases where recovery was delayed for more than 3 weeks. Results: Total numbers of admissions in obstetric ward were 3,285. Pregnancy related acute renal failure was found in 35 (1.065%) women. Age ranged from 18-40 years. Most of the women belonged to age group 30-35. Out of 35 women 31.42% had postpartum haemorrhage. Ante partum haemorrhage was found in 25.71%, Eclampsia in 17.14%, DIC in 14.28%, and sepsis in 11.42%. Anuria was observed in 25 patients, remaining presented with oliguria (28.57%). Haemodialysis was done in 75% of patients, others were managed conservatively. Complete recovery was observed in 53% cases. Maternal mortality was 25.71% and foetal mortality was 22.85%. Conclusion: Pregnancy related ARF is one of the most common causes of ARF, it is a dangerous complication of pregnancy which carries very high mortality and morbidity. (author)

Effects of Shame and Guilt on Error Reporting Among Obstetric Clinicians.

Science.gov (United States)

Zabari, Mara Lynne; Southern, Nancy L

2018-04-17

To understand how the experiences of shame and guilt, coupled with organizational factors, affect error reporting by obstetric clinicians. Descriptive cross-sectional. A sample of 84 obstetric clinicians from three maternity units in Washington State. In this quantitative inquiry, a variant of the Test of Self-Conscious Affect was used to measure proneness to guilt and shame. In addition, we developed questions to assess attitudes regarding concerns about damaging one's reputation if an error was reported and the choice to keep an error to oneself. Both assessments were analyzed separately and then correlated to identify relationships between constructs. Interviews were used to identify organizational factors that affect error reporting. As a group, mean scores indicated that obstetric clinicians would not choose to keep errors to themselves. However, bivariate correlations showed that proneness to shame was positively correlated to concerns about one's reputation if an error was reported, and proneness to guilt was negatively correlated with keeping errors to oneself. Interview data analysis showed that Past Experience with Responses to Errors, Management and Leadership Styles, Professional Hierarchy, and Relationships With Colleagues were influential factors in error reporting. Although obstetric clinicians want to report errors, their decisions to report are influenced by their proneness to guilt and shame and perceptions of the degree to which organizational factors facilitate or create barriers to restore their self-images. Findings underscore the influence of the organizational context on clinicians' decisions to report errors. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Surgical emergencies in obstetrics and gynaecology in a tertiary care hospital.

Science.gov (United States)

Pokharel, Hanoon P; Dahal, Prerana; Rai, Rubina; Budhathoki, ShyamSundar

2013-01-01

The management of Obstetrics and Gynaecological Emergency is directed at the preservation of life, health, sexual function and the perpetuation of fertility. Main aim of the study was to access the burden of Surgical Emergency in Obstetrics and Gynaecology and their course of management at BPKIHS. A total of 314 women presenting at the emergency admission room of Obstetrics and Gynaecology Department of BPKIHS over two years, who required surgical intervention were included in this hospital based descriptive study. Clinical assessment and routine laboratory investigations were performed in all cases. All patients who presented with shock were resuscitated and surgery was done at earliest possible time. The age of patients ranged from 15- 55 years with approximately 43% in the 25-34 years category. Ninety two percent of them were married. Among the unmarried, 64% came with problems related to unsafe abortion. About 61% of females presenting as acute surgical abdomen had ruptured ectopic pregnancy, 7.64% had twisted ovarian cyst, and 6.26% had haemoperitoneum and pyoperitoneum following vaginal hysterectomies, total abdominal hysterectomies and caesarean section. Almost half (47.8%) of the cases underwent salphingectomy. Women present with wide range of complaints and conditions in the admission room of Obstetrics and Gynecology department of BPKIHS. Skilled clinicians, immediate investigation facilities and experienced specialty Obstetrical and Gynaecological surgeons are the main backbone of the emergency case management and saving lives. Study indicates there is need of some prospective study to establish the causes of rising trend in Ectopic Pregnancies.

The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities

Science.gov (United States)

Kozhimannil, Katy B.; Casey, Michelle M.; Hung, Peiyin; Han, Xinxin; Prasad, Shailendra; Moscovice, Ira S.

2015-01-01

Purpose The purpose of this study was to describe the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals. Methods We conducted a telephone survey of 306 rural hospitals in 9 states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin, from November 2013-March 2014 to assess their obstetric workforce. Bivariate associations between hospitals’ annual birth volume and obstetric workforce characteristics were examined, as well as qualitative analysis of workforce changes and staffing challenges. Findings Hospitals with lower birth volume (< 240 births per year) are more likely to have family physicians and general surgeons attending deliveries, while those with a higher birth volume more frequently have obstetricians and midwives attending deliveries. Reported staffing challenges include scheduling, training, census fluctuation, recruitment and retention, and intra-hospital relationships. Conclusions Individual hospitals working in isolation may struggle to address staffing challenges. Federal and state policy makers, regional collaboratives, and health care delivery systems can facilitate solutions through programs such as telehealth, simulation training, and interprofessional education. PMID:25808202

A rule-based reference resolution method for Dutch discourse

NARCIS (Netherlands)

Harabagiu, S.; op den Akker, Hendrikus J.A.; Hospers, M.A.; Ferrandez, A.; Kroezen, Erna; Nijholt, Antinus; Lie, Danny

2002-01-01

This paper presents a knowledge-poor method for the solution of anaphoric and deictic expressions in Dutch texts. The method is developed for use in a text summarization system. Anaphora resolution plays an important role in the analysis of the original text as well as in the generation of the text

Dutch social housing sector reforms : Exploring the effects on low income households

NARCIS (Netherlands)

De Groen, A.; Pruyt, E.; Boumeester, H.J.F.M.

2012-01-01

Social rental housing ought to function as safety net for the lower income groups in the housing system. However, the Dutch housing system has a relatively large social housing stock in relation to other housing systems in Europe – larger than would be required for a safety net for lower income

[Surgical methods for delivery in modern obstetrics and their influence on maternal and infant health].

Science.gov (United States)

Kokhanevych, Ie V; Mitsoda, R M; Konoplianko, T V; Konoplianko, V V

2000-03-01

The article addresses issues of comparative characterization of deliveries involving surgery and impact thereof on the health of the mother and her child. Risk factors are identified that the mother and her child run in sectio cesarea, in application of obstetrical forceps, and in vacuum-extraction of the fetus. Cesarean section was found out to be the most acceptable mode of delivery in origination of organic and functional nervous system involvement in children but the most ill-chosen and unpropitious one in the mother, especially so in those groups at risk for bleeding, septic complications, and genital endometriosis. Among those surgical methods of delivery being the least traumatic to the mother are obstetrical forceps and vacuum-extraction of the fetus.

[Anemic syndrome frequency in complicated obstetrical patients].

Science.gov (United States)

Martínez, Maria Guadalupe Veloz; Erasto, Luis Cruz; Maxines, Claudia García; Rodríguez, María Antonia Basavilvazo; Valencia, Marcelino Hernández

2008-09-01

The prevalence of anemia varies from country to country and there is not a trustworthy record. To determine the frequency of anemia in obstetric patients and the association among healthy pregnancy and aggregate complications. Was carried out as transversal, observational and comparative study. Obstetrical patients entered and responded in the period of a year, were formed a group with normal pregnancy and another with complicated pregnancy, with a total sample of 194 patients. In the statistical analysis was employed Student t test for independent groups, with value if p anemia was found in 22.4%. Hematological stage from group with normal pregnancy was mild anemia in 16.9% and anemia moderated in 4.1% of the cases. The anemia degrees in the group with associated illness and pregnancy were mild anemia in 19.2% and moderated anemia in 4.2%. Not any case was found with severe anemia. The statistical analysis showed difference significant among both groups p preeclampsia severe (22.6%), type 2 diabetes (13.9%), gestational diabetes (12.2%) and the remainder with other complications that include to the hypertiroidism, rheumatoid arthritis, lupus, asthma and vein deep thrombosis. Frequency of anemia in this study was greater upon informing in the international literature. The obstetrical complication more frequently relates to diverse anemia degrees were the hypertensive stage during pregnancy. The anemia is presented with greater frequency in pregnancy patients with others associated illness.

Community awareness about risk factors, presentation and prevention and obstetric fistula in Nabitovu village, Iganga district, Uganda.

Science.gov (United States)

Kasamba, Nassar; Kaye, Dan K; Mbalinda, Scovia N

2013-12-10

Obstetric fistula is a worldwide problem that is devastating for women in developing countries. The cardinal cause of obstetric fistula is prolonged obstructed labour and delay in seeking emergency obstetric care. Awareness about obstetric fistula is still low in developing countries. The objective was to assess the awareness about risk factors of obstetric fistulae in rural communities of Nabitovu village, Iganga district, Eastern Uganda. A qualitative study using focus group discussion for males and females aged 18-49 years, to explore and gain deeper understanding of their awareness of existence, causes, clinical presentation and preventive measures for obstetric fistula. Data was analyzed by thematic analysis. The majority of the women and a few men were aware about obstetric fistula, though many had misconceptions regarding its causes, clinical presentation and prevention. Some wrongly attributed fistula to misuse of family planning, having sex during the menstruation period, curses by relatives, sexually transmitted infections, rape and gender-based violence. However, others attributed the fistula to delays to access medical care, induced abortions, conception at an early age, utilization of traditional birth attendants at delivery, and some complications that could occur during surgical operations for difficult deliveries. Most of the community members interviewed were aware of the risk factors of obstetric fistula. Some respondents, predominantly men, had misconceptions/myths about risk factors of obstetric fistula as being caused by having sex during menstrual periods, poor usage of family planning, being a curse.

Seed bank characteristics of Dutch plant communities

NARCIS (Netherlands)

Bekker, RM; Schaminee, JHJ; Bakker, JP; Thompson, K

With the recent appearances of a new and well-documented classification of the Dutch plant communities (Schaminee et al 1995a,b; 1996) and a database on the seed longevity of plant species of North West Europe (Thompson ct al. 1997a) it was possible to investigate patterns of seed longevity in Dutch

‘British Capital, Industry and Perseverance’ versus Dutch ‘Old School’?: The Dutch Atlantic and the Takeover of Berbice, Demerara and Essequibo, 1750-1815

Directory of Open Access Journals (Sweden)

Gert Oostindie

2012-12-01

Full Text Available Recent historiography has reconsidered the idea that the Dutch role in the early modern Atlantic was of little significance, particularly in comparison to the accomplishments of the Dutch East India Company (voc in Asia. Revisionist studies have emphasised that in spite of the limited and fragmented nature of the Dutch Atlantic ‘empire’, the Atlantic contribution to the Dutch economy was significant and possibly even greater than the voc’s share. Moreover, this scholarship stresses the vital role of Dutch Atlantic colonies (Curaçao and St Eustatius, (partly Jewish networks and individuals in connecting the various subempires of the Atlantic. While Oostindie subscribes to many of these conclusions, he argues against excessive revisionism. His analysis of the development of the lesser Dutch Guianas, adjacent to Suriname, is used as a counter-weight to this revisionist impulse. He demonstrates that the spectacular economic and demographic development of these colonies was due mainly to British and (British American involvement culminating in the eventual British takeover of ‘Guiana’.

"Womb with a View": The Introduction of Western Obstetrics in Nineteenth-Century Siam.

Science.gov (United States)

Pearson, Quentin Trais

2016-01-01

This article focuses on the historical confrontation between Western obstetrical medicine and indigenous midwifery in nineteenth-century Siam (Thailand). Beginning with the campaign of medical missionaries to reform Siamese obstetrical care, it explores the types of arguments that were employed in the contest between these two forms of expert knowledge. Missionary-physicians used their anatomical knowledge to contest both particular indigenous obstetrical practices and more generalized notions concerning its moral and metaphysical foundations. At the same time, by appealing to the health and well-being of the consorts and children of the Siamese elite, they gained access to the intimate spaces of Siamese political life. The article contends that the medical missionary campaign intersected with imperial desires to make the sequestered spaces of Siamese political life more visible and accessible to Western scrutiny. It therefore reveals the imbrication of contests over obstetrical medicine and trade diplomacy in the imperial world.

Lexicon Optimization for Dutch Speech Recognition in Spoken Document Retrieval

NARCIS (Netherlands)

Ordelman, Roeland J.F.; van Hessen, Adrianus J.; de Jong, Franciska M.G.

In this paper, ongoing work concerning the language modelling and lexicon optimization of a Dutch speech recognition system for Spoken Document Retrieval is described: the collection and normalization of a training data set and the optimization of our recognition lexicon. Effects on lexical coverage

Lexicon optimization for Dutch speech recognition in spoken document retrieval

NARCIS (Netherlands)

Ordelman, Roeland J.F.; van Hessen, Adrianus J.; de Jong, Franciska M.G.; Dalsgaard, P.; Lindberg, B.; Benner, H.

2001-01-01

In this paper, ongoing work concerning the language modelling and lexicon optimization of a Dutch speech recognition system for Spoken Document Retrieval is described: the collection and normalization of a training data set and the optimization of our recognition lexicon. Effects on lexical coverage

Prenatal emotion management improves obstetric outcomes: a randomized control study.

Science.gov (United States)

Huang, Jian; Li, He-Jiang; Wang, Jue; Mao, Hong-Jing; Jiang, Wen-Ying; Zhou, Hong; Chen, Shu-Lin

2015-01-01

Negative emotions can cause a number of prenatal problems and disturb obstetric outcomes. We determined the effectiveness of prenatal emotional management on obstetric outcomes in nulliparas. All participants completed the PHQ-9 at the baseline assessment. Then, the participants were randomly assigned to the emotional management (EM) and usual care (UC) groups. The baseline evaluation began at 31 weeks gestation and the participants were followed up to 42 days postpartum. Each subject in the EM group received an extra EM program while the participants in the UC groups received routine prenatal care and education only. The PHQ-9 and Edinburgh Postnatal Depression scale (EPDS) were used for assessment. The EM group had a lower PHQ-9 score at 36 weeks gestation, and 7 and 42 days after delivery (P Prenatal EM intervention could control anxiety and depressive feelings in nulliparas, and improve obstetric outcomes. It may serve as an innovative approach to reduce the cesarean section rate in China.

Will you give birth in pain? Integrative review of obstetric violence in Brazilian public units

OpenAIRE

Martins, Aline de Carvalho; Barros, Geiza Martins

2016-01-01

ABSTRACT BACKGROUND AND OBJECTIVES: The study aimed at providing further visibility to discussions about obstetric violence suffered by Brazilian women in public health institutions. CONTENTS: This was an integrative review of the last decade, where 100 articles were evaluated to identify how Obstetric Violence is in Brazilian public health units. CONCLUSION: Identified obstetric violences were: institutional violence, moral violence, physical violence, sexual violence, psychological and v...

A STUDY ON THE RISK FACTORS FOR OBSTETRICAL BRACHIAL PLEXUS PALSY

OpenAIRE

Farah ASHRAFZADEH; Hasan BOSKABADI; Mohammad FARAJI RAD; Parisa SEYYED HOSSEINEE

2011-01-01

ObjectiveConsiderable medical and legal debates have surrounded the prognosis and outcome of obstetrical brachial plexus injuries and obstetricians are oftenconsidered responsible for the injury. In this study, we assessed the factors related to the outcome of brachial plexus palsy.Material & MethodsDuring 24 months, 21 neonates with obstetrical brachial plexus injuries were enrolled.Electrophysiology studies were done at the age of three weeks. They received physiotherapy and occupational th...

Animal models in fetal medicine and obstetrics

DEFF Research Database (Denmark)

Dahl Andersen, Maria; Alstrup, Aage Kristian Olsen; Duvald, Christina Søndergaard

2018-01-01

Animal models remain essential to understand the fundamental mechanisms occurring in fetal medicine and obstetric diseases, such as intrauterine growth restriction, preeclampsia and gestational diabetes. These vary regarding the employed method used for induction of the disease, and vary regardin...

Training in Emergency Obstetrics: A Needs Assessment of U.S. Emergency Medicine Program Directors

Directory of Open Access Journals (Sweden)

Daniel W. Robinson

2017-12-01

Full Text Available Introduction Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs. Methods We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH, shoulder dystocia, and breech presentation through email invitations to all program directors (PD of U.S. EM residency programs. The survey focused on curricular details as well as the comfort level of the PDs in the preparation of their graduating residents to treat obstetrical emergencies and normal vaginal deliveries. Results Our survey had a 55% return rate (n=105/191. Of the residencies responding, 75% were in the academic setting, 20.2% community, 65% urban, and 29.8% suburban, and the obstetrical curricula were 2–4 weeks long occurring in post-graduate year one. The most common teaching method was didactics (84.1–98.1%, followed by oral cases for pre-eclampsia (48% and PPH (37.2%, and homemade simulation for shoulder dystocia (37.5% and breech delivery (33.3%. The PDs’ comfort about residency graduate skills was highest for normal spontaneous vaginal delivery, pre-eclampsia, and PPH. PDs were not as comfortable about their graduates’ skill in handling shoulder dystocia or breech delivery. Conclusion Our survey found that PDs are less comfortable in their graduates’ ability to perform non-routine emergency obstetrical procedures.

Obstetrical nursing and health education: contributions to the experience of process of parturition

Directory of Open Access Journals (Sweden)

Jacqueline Silveira de Quadros

2016-01-01

Full Text Available Objective: to understand the contributions of obstetrical nursing to health education activities aimed at the parturition process. Methods: qualitative research conducted with ten hospitalized puerperal women who had vaginal delivery in a maternity ward. Results: two categories emerged from the data of this research: Weaknesses of prenatal care for pregnant women and The obstetrical nurse as potentiator of humanized care. Conclusion: obstetrical nursing, through educational work, strives to promote a reframing of the process of parturition, rescuing parturition as a physiological process, and emphasizing the use of natural resources in the evolution of labor and delivery.

Effects of obstetric gel on the process and duration of labour in pregnant women: Randomised controlled trial.

Science.gov (United States)

Seval, Mehmet Murat; Yüce, Tuncay; Yakıştıran, Betül; Şükür, Yavuz Emre; Özmen, Batuhan; Atabekoğlu, Cem; Koç, Acar; Söylemez, Feride

2017-08-01

The present study investigated maternal and neonatal outcomes in pregnant women who used obstetric lubricant gels during active labour. This prospective randomised controlled study included 180 pregnant women. Women were randomly assigned to two groups during the first-stage of labour. Pregnant women in the obstetric gel group received standard antepartum care plus vaginal application of obstetric gel. Women in the control group received standard antepartum care without obstetric gel. Mean duration of the second stage of labour was significantly shorter in the obstetric gel group than control group (45 ± 34 min vs. 58 ± 31 min, respectively; p = .005). Mean APGAR values at 5 min were significantly higher in the obstetric gel group (9.5 ± 0.6 vs. 9.2 ± 0.7; p = .0014). Among nulliparous women, mean duration of the second stage of labour was significantly shorter in the gel group than control group (53 ± 52 min vs. 83 ± 45 min, respectively; p = .003). Using obstetric gel at the beginning of the first stage decreases the length of the second stage of labour, particularly in nulliparous women, and may be associated with an improved APGAR score at 5 min. Impact statement A limited number of studies in the literature have demonstrated that obstetric gels shorten the second stage of labour and are protective for the pelvic floor. The results of this study show that using obstetric gel shortens the second stage of labour in only nulliparous, but not multiparous women. In addition, a significant improvement in the 5 min APGAR score was seen in the neonates of women who used obstetric gel. The application of obstetric gels during the labour of nulliparous women may be a useful clinical practice and may have a widespread use in the future.

Young Asian Dutch constructing Asianness: Understanding the role of Asian popular culture

OpenAIRE

Kartosen, R.A.

2016-01-01

This doctoral thesis is about young Asian Dutch, panethnic Asian identities and identifications, and Asian/Asian Dutch popular culture. It addresses several pressing questions, including: why do young Asian Dutch, who were born and/or raised in the Netherlands, identify as Asian and construct Asian identities? What is the content or meaning of these Asian identities and identifications young Asian Dutch imagine? And how do these relate to young Asian Dutch’ Dutch and homeland identities and i...

The obstetric nightmare of shoulder dystocia: a tale from two perspectives.

Science.gov (United States)

Beck, Cheryl Tatano

2013-01-01

Shoulder dystocia is one of the most terrifying of obstetric emergencies. In this secondary analysis of two qualitative studies, the experiences of shoulder dystocia are compared and contrasted from two perspectives: the mothers and the labor and delivery nurses. In the first study mothers' experiences of shoulder dystocia and caring for their children with obstetric brachial plexus injuries were explored. The second study explored secondary traumatic stress in labor and delivery nurses due to exposure to traumatic births. Krippendorff's content analysis technique of clustering was used to identify data that could be grouped together into themes. It was striking how similar the perspectives of mothers and their nurses were regarding a shoulder dystocia birth. Four themes emerged from the content analysis of these two data sets: (1) in the midst of the obstetric nightmare; (2) reeling from the trauma that just transpired; (3) enduring heartbreak: the heavy toll on mothers; and (4) haunted by memories: the heavy toll on nurses. Providing emotional support to the mother during shoulder dystocia births and afterward in the postpartum period has been acknowledged. What now needs to be added to best practices for shoulder dystocia are interventions for the nurses themselves. Support for labor and delivery nurses who are involved in this obstetric nightmare is critical.

Reasons for accepting or declining Down syndrome screening in Dutch prospective mothers within the context of national policy and healthcare system characteristics : a qualitative study

NARCIS (Netherlands)

Crombag, Neeltje M T H; Boeije, Hennie; Iedema-Kuiper, Rita; Schielen, Peter C J I; Visser, Gerard H A; Bensing, Jozien M

2016-01-01

BACKGROUND: Uptake rates for Down syndrome screening in the Netherlands are low compared to other European countries. To investigate the low uptake, we explored women's reasons for participation and possible influences of national healthcare system characteristics. Dutch prenatal care is

Optimization of the central automatic control of a small Dutch sewer system

Science.gov (United States)

Kolechkina, A. G.; Hoes, O. A. C.

2012-04-01

A sewer control system was developed in the context of a subsidized project aiming at improvement of surface water quality by control of sewer systems and surface water systems. The project was coordinated by the local water board, "Waterschap Hollandse Delta". Other participants were Delft University of Technology, Deltares and the municipalities Strijen, Cromstrijen, Westmaas, Oud Beijerland and Piershil. As part of the project there were two pilot implementations where a central automatic controller was coupled to the existing SCADA system. For these two pilots the system is now operational. A Dutch urban area in the western part of the Netherlands is usually part of a polder, which is effectively an artificially drained catchment. The urban area itself is split into small subcatchments that manage runoff in different ways. In all cases a large fraction goes into the natural hydrological cycle, but, depending on the design of the local sewer system, a larger or smaller part finds its way into the sewer system. Proper control of this flow is necessary to control surface water quality and to avoid health risks from flow from the sewer into the streets. At each time step the controller switches pumps to distribute the remaining water in the system at the end of the time step over the different subcatchments. The distribution is created based on expert judgment of the relative vulnerability and subcatchment sewer system water quality. It is implemented in terms curves of total system stored volume versus subcatchment stored volume. We describe the process of the adaptation of a controller to two different sewer systems and the understanding of the artificial part of the catchment we gained during this process. In the process of adaptation the type of sewer system (combined foul water and storm water transport or separate foul water and storm water transport) played a major role.

Network investments and the integration of distributed generation: Regulatory recommendations for the Dutch electricity industry

International Nuclear Information System (INIS)

Niesten, Eva

2010-01-01

An increase in the distributed generation of electricity necessitates investments in the distribution network. The current tariff regulation in the Dutch electricity industry, with its ex post evaluation of the efficiency of investments, average benchmarking and a frontier shift in the x-factor, delays these investments. In the unbundled electricity industry, the investments in the network need to be coordinated with those in the distributed generation of electricity to enable the system operators to build enough network capacity. The current Dutch regulations do not provide for a sufficient information exchange between the generators and the system operators to coordinate the investments. This paper analyses these two effects of the Dutch regulations, and suggests improvements to the regulation of the network connection and transportation tariffs to allow for sufficient network capacity and coordination between the investments in the network and in the generation of electricity. These improvements include locally differentiated tariffs that increase with an increasing concentration of distributed generation.

Obstetric and vascular APS: same autoantibodies but different diseases?

Science.gov (United States)

Meroni, P L; Raschi, E; Grossi, C; Pregnolato, F; Trespidi, L; Acaia, B; Borghi, M O

2012-06-01

Beta2 glycoprotein I (β2GPI)-dependent antiphospholipid antibodies (aPLs) are the main pathogenic autoantibody population and at the same time the laboratory diagnostic tool for the antiphospholipid syndrome (APS). These antibodies are responsible for both the vascular and the obstetric manifestations of the syndrome but the pathogenic mechanisms behind these manifestations are not the same. For example, thrombotic events do not appear to play a major role in APS miscarriages and a direct reactivity of β2GPI-dependent aPLs on decidual and trophoblast cells was reported. A local expression of β2GPI on these tissues was reported both in physiological conditions and in APS women, thus explaining the local tropism of the autoantibodies. The two hit hypothesis was suggested to explain why the vascular manifestations of APS may occur only occasionally in spite of the persistent presence of aPLs. This is not apparently the case for the obstetric variant of the syndrome, making the difference even more striking. A different pathogenesis may also provide the rationale for the well-known fact that the vascular and the obstetric manifestations may occur independently although in a minority of cases.

Urinary tract infection among obstetric fistula patients at Gondar University Hospital, northwest Ethiopia.

Science.gov (United States)

Wondimeneh, Yitayih; Muluye, Dagnachew; Alemu, Abebe; Atinafu, Asmamaw; Yitayew, Gashaw; Gebrecherkos, Teklay; Alemu, Agersew; Damtie, Demekech; Ferede, Getachew

2014-01-17

Many women die from complications related to pregnancy and childbirth. In developing countries particularly in sub-Saharan Africa and Asia, where access to emergency obstetrical care is often limited, obstetric fistula usually occurs as a result of prolonged obstructed labour. Obstetric fistula patients have many social and health related problems like urinary tract infections (UTIs). Despite this reality there was limited data on prevalence UTIs on those patients in Ethiopia. Therefore, the aim of this study was to determine the prevalence, drug susceptibility pattern and associated risk factors of UTI among obstetric fistula patients at Gondar University Hospital, Northwest Ethiopia. A cross sectional study was conducted from January to May, 2013 at Gondar University Hospital. From each post repair obstetric fistula patients, socio-demographic and UTIs associated risk factors were collected by using a structured questionnaire. After the removal of their catheters, the mid-stream urine was collected and cultured on CLED. After overnight incubation, significant bacteriuria was sub-cultured on Blood Agar Plate (BAP) and MacConkey (MAC). The bacterial species were identified by series of biochemical tests. Antibiotic susceptibility test was done by disc diffusion method. Data was entered and analyzed by using SPSS version 20. A total of 53 post repair obstetric fistula patients were included for the determination of bacterial isolate and 28 (52.8%) of them had significant bacteriuria. Majority of the bacterial isolates, 26 (92.9%), were gram negative bacteria and the predominant ones were Citrobacter 13 (24.5%) and E. coli 6 (11.3%). Enterobacter, E.coli and Proteus mirabilis were 100% resistant to tetracycline. Enterobacter, Proteus mirabilis, Klebsella pneumonia, Klebsella ozenae and Staphylococcus aureus were also 100% resistant to ceftriaxone. The prevalence of bacterial isolates in obstetric fistula patients was high and majority of the isolates were gram

Obstetric controversies in thyroidology

Directory of Open Access Journals (Sweden)

Ambika Gopalakrishnan Unnikrishnan

2013-01-01

Full Text Available It is well known that thyroid disorders commonly affect women. The care of pregnant women affected by thyroid disease is an important clinical challenge for endocrinologists. Hypothyroidism is the commonest problem, and maternal hypothyroxinemia has been linked to adverse feto-maternal outcomes. This article would discuss the controversy regarding first-trimester thyroid hormone deficiency and fetal brain development. Certain obstetric controversies in the management of hyperthyroidism in pregnancy, including the indications of TSH receptor antibody measurements and fetal thyroid status monitoring would also be discussed.

Learning to read Dutch as a transparent orthography

NARCIS (Netherlands)

Verhoeven, L.T.W.

2017-01-01

The present longitudinal study investigated the growth of word reading fluency in Dutch as a transparent orthography as a function of meaning (words vs pseudowords) and orthographic complexity throughout the elementary school years. For a representative sample of 511 Dutch children, decoding

The impact of farm size on sustainability of dutch dairy farms

NARCIS (Netherlands)

Meulen, van der H.A.B.; Dolman, M.A.; Jager, J.H.; Venema, G.S.

2014-01-01

Sustainable milk production systems require economically viable, environmentally sound and socially acceptable practices. This study compared the economic, environmental and societal impact of large-scale farms with other dairy farms in the Dutch Farm Accountancy Data Network (FADN). Moreover the

Dutch Energy Investment Allowance (EIA). Energy List for 2013; Energie-investeringsaftrek (EIA). Energielijst 2013

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-01-15

The Energy Investment Allowance (EIA) is a tax system by means of which the Dutch government supports companies with investments in energy-saving equipment and renewable energy. This brochure explains the assets eligible for EIA and how the scheme works [Dutch] De Energie-investeringsaftrek (EIA) is een fiscale regeling waarmee de overheid ondersteuning biedt voor bedrijven bij investeringen in energiebesparende bedrijfsmiddelen en duurzame energie. In deze brochure wordt uitgelegd welke bedrijfsmiddelen in aanmerking komen voor EIA en hoe de regeling werkt.

Neuter is not Common in Dutch : Eye Movements Reveal Asymmetrical Gender Processing

NARCIS (Netherlands)

Loerts, Hanneke; Wieling, Martijn; Schmid, Monika S.

2013-01-01

Native speakers of languages with transparent gender systems can use gender cues to anticipate upcoming words. To examine whether this also holds true for a non-transparent two-way gender system, i.e. Dutch, eye movements were monitored as participants followed spoken instructions to click on one of

Marketing the nursing practice of obstetrics.

Science.gov (United States)

Dill, P Z

1991-01-01

This article offers nurses a conceptual framework for marketing their skills and discusses how that framework can be applied to obstetric nursing practice. A thorough understanding of the framework presented will provide maternity nurses with the foundation they need to participate effectively in a marketing plan. Examples of the application of the framework to specific clinical situations are examined.

Building Comprehensive Strategies for Obstetric Safety: Simulation Drills and Communication.

Science.gov (United States)

Austin, Naola; Goldhaber-Fiebert, Sara; Daniels, Kay; Arafeh, Julie; Grenon, Veronique; Welle, Dana; Lipman, Steven

2016-11-01

As pioneers in the field of patient safety, anesthesiologists are uniquely suited to help develop and implement safety strategies to minimize preventable harm on the labor and delivery unit. Most existing obstetric safety strategies are not comprehensive, lack input from anesthesiologists, are designed with a relatively narrow focus, or lack implementation details to allow customization for different units. This article attempts to address these gaps and build more comprehensive strategies by discussing the available evidence and multidisciplinary authors' local experience with obstetric simulation drills and optimization of team communication.

Dosimetric substantiation of the use of radionuclide methods in obstetrics

International Nuclear Information System (INIS)

Volobuev, A.I.; Filatov, V.I.; Turaev, R.N.

1987-01-01

The problem of a possible use of radionuclide methods of investigation (placentography and renography) in obstetrics was considered. Doses and permissibles activities in pregnant women of the AP category belonging to groups at high risk of obstetric and perinated pathology were worked out on the basis of the ''Rules and standards of open radiopharmaceuticals in diagnostic purposes'' (1984). The above investigations using the administration of short-lived radionuclides with total activity of 7.4 MBq ( 99m Tc-albumin and DTPA) were shown to be safe for mother and fetus

Resuscitation and Obstetrical Care to Reduce Intrapartum-Related Neonatal Deaths: A MANDATE Study.

Science.gov (United States)

Kamath-Rayne, Beena D; Griffin, Jennifer B; Moran, Katelin; Jones, Bonnie; Downs, Allan; McClure, Elizabeth M; Goldenberg, Robert L; Rouse, Doris; Jobe, Alan H

2015-08-01

To evaluate the impact of neonatal resuscitation and basic obstetric care on intrapartum-related neonatal mortality in low and middle-income countries, using the mathematical model, Maternal and Neonatal Directed Assessment of Technology (MANDATE). Using MANDATE, we evaluated the impact of interventions for intrapartum-related events causing birth asphyxia (basic neonatal resuscitation, advanced neonatal care, increasing facility birth, and emergency obstetric care) when implemented in home, clinic, and hospital settings of sub-Saharan African and India for 2008. Total intrapartum-related neonatal mortality (IRNM) was acute neonatal deaths from intrapartum-related events plus late neonatal deaths from ongoing intrapartum-related injury. Introducing basic neonatal resuscitation in all settings had a large impact on decreasing IRNM. Increasing facility births and scaling up emergency obstetric care in clinics and hospitals also had a large impact on decreasing IRNM. Increasing prevalence and utilization of advanced neonatal care in hospital settings had limited impact on IRNM. The greatest improvement in IRNM was seen with widespread advanced neonatal care and basic neonatal resuscitation, scaled-up emergency obstetric care in clinics and hospitals, and increased facility deliveries, resulting in an estimated decrease in IRNM to 2.0 per 1,000 live births in India and 2.5 per 1,000 live births in sub-Saharan Africa. With more deliveries occurring in clinics and hospitals, the scale-up of obstetric care can have a greater effect than if modeled individually. Use of MANDATE enables health leaders to direct resources towards interventions that could prevent intrapartum-related deaths. A lack of widespread implementation of basic neonatal resuscitation, increased facility births, and emergency obstetric care are missed opportunities to save newborn lives.

[Current value, technic and indications for obstetrical operations].

Science.gov (United States)

Bayer, H

1983-01-01

Starting point of this survey is the 1954 paper about obstetrical operations from H. Kraatz. It is demonstrated, that there were and there are defined principles, which continue to exist unchanged. They are the fundamentals of indication and technique of operations in obstetrics. Nevertheless there are distinct changes, too, caused by two factors, progress in medicine (development of antibiotics, anaesthesiology and neonatology) as well as change of aspect in obstetrics (e.g. toxemias of pregnancy, preterm labour). The methods are discussed in detail. Operations by vaginal route come in the foreground in the last years more again. They should be preferred in maternal interest. The enlarged indication for caesarean section was not able to succeed on a large scale. An uniform procedure is proposed both in cephalic and breech presentation, and the new formulated preconditions to these operations are discussed. All three techniques two abdominal ones and one vaginal one) are demanded in caesarean sections, because they come into question in special situations. There is a change in operative indications in cases of bleeding, because of an early diagnosis by ultrasound. The qualification and experience of the obstetrician is more decisive than the selected method of operation or the instrument's type. Therefore there should not be any cut in instruction and training. The versatility of operative technique is a prerequisite to a qualified indication.

The role of caesarean section in modern Obstetrics

Directory of Open Access Journals (Sweden)

Alessandra Meloni

2012-10-01

Full Text Available Caesarean section (CS is a safe obstetric surgical procedure that contributes to reducing maternal and perinatal mortality and morbidity. Nevertheless, its advantages do not justify its continuous increase. During the last few years an average of 35% of deliveries have occurred by CS in Italy whereas an average of 20-25% is very common in other western countries. Although these percentages are very different, an important issue of modern obstetric Medicine is to ascertain whether the threshold of 15% proposed by the WHO in 1985 is actually adequate. Different medical, cultural, social, economic and medico-legal issues are of concern in the different countries and in contemporary society compared with the past. If we wish to discuss whether a new threshold should be proposed to reach the best balance between risks and benefits of CS in modern Obstetrics, it is mandatory to evaluate the reasons why these high percentages of CS occur in western countries and, in particular, in Italy. To reach this goal an optimal management of the delivery room should be pursued by implementing an organizational program, considering the objective delivery trend (Robson’s ten group classification and organizing continuous audit processes. The potential concern for the medico-legal issue, women’s choice and the use of analgesia in childbirth must be taken into account.

Cost efficiency of waste management in Dutch municipalities

NARCIS (Netherlands)

de Groot, Hans; van Heezik, A.; Hollanders, D.; Felsö, F.

2011-01-01

This paper analyses the cost efficiency of waste management of Dutch municipalities. For the first time stochastic frontier analysis is applied to Dutch data, employing recent multi-year data (2005-2008). The preliminary findings confirm earlier results on the importance for cost efficiency of

System theory and safety models in Swedish, UK, Dutch and Australian road safety strategies.

Science.gov (United States)

Hughes, B P; Anund, A; Falkmer, T

2015-01-01

Road safety strategies represent interventions on a complex social technical system level. An understanding of a theoretical basis and description is required for strategies to be structured and developed. Road safety strategies are described as systems, but have not been related to the theory, principles and basis by which systems have been developed and analysed. Recently, road safety strategies, which have been employed for many years in different countries, have moved to a 'vision zero', or 'safe system' style. The aim of this study was to analyse the successful Swedish, United Kingdom and Dutch road safety strategies against the older, and newer, Australian road safety strategies, with respect to their foundations in system theory and safety models. Analysis of the strategies against these foundations could indicate potential improvements. The content of four modern cases of road safety strategy was compared against each other, reviewed against scientific systems theory and reviewed against types of safety model. The strategies contained substantial similarities, but were different in terms of fundamental constructs and principles, with limited theoretical basis. The results indicate that the modern strategies do not include essential aspects of systems theory that describe relationships and interdependencies between key components. The description of these strategies as systems is therefore not well founded and deserves further development. Copyright © 2014 Elsevier Ltd. All rights reserved.

Urological injuries following obstetrical and gynecological surgeries ...

African Journals Online (AJOL)

Background: Gynaecological operations have been reported to be associated with injuries to the ureter. This study was aimed at reviewing the urological complications resulting from obstetric and gynaecological surgeries in respect to frequency, clinical presentations, and time of diagnosis. The study was undertaken at ...

Low birthweght babies: Socio-demographic and obstetric ...

African Journals Online (AJOL)

Although the obstetric factors of antenatal clinic attendance, premature rupture of the membranes, pre-eclamptic toxaemia, infections and interventronal delivery tended to be more frequent among the adolescent mothers, non of these differences were significant probably due to the small numbers of patients studied.

Do Dutch nutrition and dietetics students meet nutritional requirements during education?

NARCIS (Netherlands)

van der Kruk, Joke; Jager, Harriët; Nieweg, Roos; van der Schans, Cees

2014-01-01

OBJECTIVES: To compare the dietary intakes of Dutch nutrition and dietetics students with the Dutch RDA and the Dutch National Food Consumption Survey (DNFCS), and to assess whether dietary intake changes during education.DESIGN: Cross-sectional and longitudinal research (2004-2010).SETTING: Data

The effect of antenatal education in small classes on obstetric and psycho-social outcomes

DEFF Research Database (Denmark)

Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Lauemøller, Stine Glenstrup

2015-01-01

of small group antenatal education on obstetric and psycho-social outcomes. CONCLUSIONS: Insufficient evidence exists as to whether antenatal education in small classes is effective in regard to obstetric and psycho-social outcomes. We recommend updating this review following the emergence of well......, with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. METHODS...

[Clinical study of 12 cases with obstetric mirror syndrome].

Science.gov (United States)

Wu, Lin-lin; Wang, Chen-hong; Li, Zhi-quan

2012-03-01

To discuss the clinical features, management, pregnancy outcome and prognosis of obstetric mirror syndrome. The clinical data of 12 cases with obstetric mirror syndrome at Shenzhen Maternity and Child Healthcare Hospital from April 2008 to December 2010 were collected to retrospectively analyze the clinical features, management, pregnancy outcome and prognosis. (1) ETIOLOGY: 12 cases with obstetric mirror syndrome included 9 cases of Bart's hydrops fetalis, 2 cases with fetal complicated congenital cardiac anomalies, and 1 case of unknown etiology. (2) Gestational age at diagnosis and at delivery: gestational age at diagnosis ranged from 28 to 36 weeks [mean (31.5 ± 4.7) weeks], and gestational age at delivery ranged from 28(+3) to 38 weeks [mean (32.9 ± 2.9) weeks]. There were no significant differences between the gestational age at diagnosis and at delivery in consistence with severe preeclampsia group and mild preeclampsia group [(31.8 ± 2.3) weeks vs. (30.9 ± 7.2) weeks, (32.5 ± 2.3) weeks vs. (33.5 ± 3.9) weeks, P > 0.05]. (3) The patients with obstetric mirror syndrome can present a preeclampsia-like syndrome: maternal extremity edema in 12 cases, headache and visual disturbance in 1 case, proteinuria in 11 cases, elevated blood pressure in 5 cases, elevated uric acid in 9 cases, hypoproteinemia in 12 cases, elevated creatinine in 3 case, elevated liver enzyme in 1 case, thrombocytopenia in 2 cases. The major complications included 1 case of HELLP syndrome, acute pulmonary edema, placental abruption, amnionic fluid embolism, DIC respectively, 3 cases of acute kidney failure and 6 cases of postpartum hemorrhage. (4) Sonographic findings: 1) Hydrops fetalis: fetal ultrasound revealed pleural fluid, fetal ascites, skin edema, scalp edema, encephalocolele enlargement, hydropericardium and increased cardio-chest ratio. 2) Placenta megaly: the placental pathological examination revealed edematous and large in 12 cases. Placental thickness was beyond 4 cm in

the dutch crisis and recovery act: economic recovery and legal crisis

African Journals Online (AJOL)

Jonathan

THE DUTCH CRISIS AND RECOVERY ACT: ECONOMIC RECOVERY AND. LEGAL CRISIS? J Verschuuren. 1 Introduction. Throughout the world, governments are responding to the financial and economic crisis. Such responses vary from supporting the banking system to adopting economic stimulus packages. The latter ...

Socialized choices: Labour market behaviour of Dutch mothers

NARCIS (Netherlands)

Ruitenberg, J.F.

2014-01-01

Dutch mothers display diverse labour market behaviour, though typically they work part-time, making modest use of childcare. It is generally assumed that Dutch women are free to make their own choices regarding employment. This narrative of 'choice' finds fertile ground in an era of general

Physical activity among Dutch workers-differences between occupations

NARCIS (Netherlands)

Proper, K.I.; Hildebrandt, V.H.

2006-01-01

Objective.: This study describes the total physical activity and the contribution of work to total physical activity among Dutch workers. The study was conducted in the Netherlands in the years 2000-2002. Methods.: 2,417 respondents of a cross-sectional survey representing the Dutch adult working

Impact of introducing specific measures to reduce the frequency of cesarean delivery for non-obstetric indications.

Science.gov (United States)

Psenkova, Petra; Bucko, Marek; Braticak, Michal; Baneszova, Ruth; Zahumensky, Jozef

2018-03-25

To identify the frequency of cesarean delivery for non-obstetric indications before and after the introduction of specific measures to lower the rate of elective cesarean, and to evaluate the effectiveness of the introduced measures. In the present single-center retrospective cohort study at University Hospital Trnava, Trnava, Slovak Republic, the frequency of elective cesarean was evaluated before (January 1, 2010, to December 31, 2014) and after (January 1, 2015, to December 31, 2016) the implementation of specific measures applied in January 2015 to confirm the indications for primary cesarean delivery. The frequency of elective cesarean delivery for non-obstetric indications was compared between the two periods. Before the intervention in 2015, 229 (2.9%) of 7768 women had elective cesarean deliveries for non-obstetric indications. After implementation of the intervention, the frequency decreased to 27 (0.8%) of 3203 women (Pdelivery for non-obstetric indications was reduced significantly by introducing specific reasonable measures. These included all non-obstetric indications for cesarean delivery being approved by a leading specialist of the related department, close cooperation with professionals from other specialties, and, additionally, staff attending professional educational lectures. © 2018 International Federation of Gynecology and Obstetrics.

Preventing the Dutch Disease: The case of Indonesia

International Nuclear Information System (INIS)

Ramli, R.

1992-01-01

Indonesia has been more successful than other oil exporters in mitigating the effects of the Dutch Disease, the decline in non-oil production associated with an oil boom. Typically sharp increases in oil revenues promote the accumulation of international reserves, increasing monetization, and raising prices of non-traded relative to traded goods. The latter causes contraction of output and employment in the traded sector. This study analyzes the magnitude of the boom and its fiscal, monetary, and production effects. Proxies of the real exchange rate, defined as the relative price of traded to non-traded goods, were constructed. The effect of the exchange rate on the Dutch Disease problems were examined. The movement of the real exchange rate and the remarkable growth of production of traded goods indicate that the effects of the Dutch Disease on the Indonesian economy were remarkably limited. Structural and policy-induced factors, such as exchange rate protection and micro interventions, that mitigated the anticipated effects of the Dutch Disease are examined

On use of ultrasonography in obstetrics and gynecology

International Nuclear Information System (INIS)

Woo, Kwang Suk; Lee, Yong Woo

1984-01-01

Ultrasonography is playing an very important in diagnosis of normal pregnancy and the other diseases in the fields of obstetrics and gynecology. It is mainly used B-mode and Real time linear scan for pregnancy such as fetal movement during its early stage, fetal position, placenta location and biparietal diameter during its middle stage, and amniotic fluid and placenta previa during its late stage, as well as tumor accompanying pregnancy. Ultrasonography has been extensively used in the fields of obstetrics and gynecology for obtaining detailed images of soft tissues without hazard to the fetus and pregnant woman. In view of the need for its professionalism of high degree of skill, this treatise will introduce clinical instances and images obtained in the sonography room of the Seoul National University Hospital

The comparability of English, French and Dutch scores on the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F: an assessment of differential item functioning in patients with systemic sclerosis.

Directory of Open Access Journals (Sweden)

Linda Kwakkenbos

Full Text Available The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F is commonly used to assess fatigue in rheumatic diseases, and has shown to discriminate better across levels of the fatigue spectrum than other commonly used measures. The aim of this study was to assess the cross-language measurement equivalence of the English, French, and Dutch versions of the FACIT-F in systemic sclerosis (SSc patients.The FACIT-F was completed by 871 English-speaking Canadian, 238 French-speaking Canadian and 230 Dutch SSc patients. Confirmatory factor analysis was used to assess the factor structure in the three samples. The Multiple-Indicator Multiple-Cause (MIMIC model was utilized to assess differential item functioning (DIF, comparing English versus French and versus Dutch patient responses separately.A unidimensional factor model showed good fit in all samples. Comparing French versus English patients, statistically significant, but small-magnitude DIF was found for 3 of 13 items. French patients had 0.04 of a standard deviation (SD lower latent fatigue scores than English patients and there was an increase of only 0.03 SD after accounting for DIF. For the Dutch versus English comparison, 4 items showed small, but statistically significant, DIF. Dutch patients had 0.20 SD lower latent fatigue scores than English patients. After correcting for DIF, there was a reduction of 0.16 SD in this difference.There was statistically significant DIF in several items, but the overall effect on fatigue scores was minimal. English, French and Dutch versions of the FACIT-F can be reasonably treated as having equivalent scoring metrics.

[Assessment of shoulder dystocia related knowledge among French obstetrics and gynecology residents].

Science.gov (United States)

Schmitt, A; Heckenroth, H; Cravello, L; Boubli, L; d'Ercole, C; Courbiere, B

2016-09-01

To study the related knowledge of French residents in obstetrics concerning maneuvers for shoulder dystocia (SD). Multicenter descriptive transversal study conducted from June to September 2014. Data collection was performed through questionnaires sent by email to French resident in obstetrics. Among the 1080 questionnaires sent, 366 responses were obtained with a response rate of 33.9%. One hundred and forty-three residents (39.1%) were in the first part of their training (≤5th semester) and 60.9% (n=223) were in the second part of their training. Theoretical training on the SD was provided to 88.2% of resident (n=323). In total, 38.8% (n=142) obtained their French degree in mechanical and technical obstetric and among them 77.5% (n=110) had the opportunity to train on simulators and dummies. Concerning their practical experiences, 31.5% (n=45) residents ≤5th semester reported having experienced SD during their residency vs 58.3% (n=130) amongst oldest residents (Pdystocia. Only 19.1% (n=70) were satisfied with their residency training program vs 39.1% (n=143) who were unsatisfied. Our study showed that less than one resident out of two (40%) felt able to perform maneuvers for SD in the second part of residency. We think that simulation activities should be mandatory for residency training programs in Obstetrics and Gynecology, which have to develop dependable measures to assess resident competencies to execute practical maneuvers for clinical emergencies in obstetrics. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Indonesianisasi of Dutch economic interests, 1930-1960 : The case of Internatio

Directory of Open Access Journals (Sweden)

Jasper van der Kerkhof

2005-01-01

Full Text Available This article looks in detail into the process of indonesianisasi at Internatio, a major Dutch trading firm in Indonesia. I draw on Dutch archival records and the voluminous Dutch and international literature on the changing environment for Dutch private business in Indonesia in the 1950s. Internatio’s case is particularly instructive for the following reasons: – Internatio was a leading trading firm in Indonesia and regarded as a ‘trendsetter’ among the so-called ‘Big Five’, the leading Dutch import houses in the archipelago. – Successive Indonesian cabinets considered import trade crucial in the process of indonesianisasi, and for this reason the sector was targeted for policies aimed at wresting control from Dutch firms and encouraging the development of indigenous ones. – Internatio had a pivotal role in the Indonesian economy due to its extensive interests, not only in import trade but also in exports, estates, manufacturing, shipping, and insurance. The article is chronologically structured, distinguishing five periods: depression and diversification (1930-1940; the end of Dutch supremacy (1940-1945; revolution and rehabilitation (1945-1950; adjusting to new realities (1950- 1956; confrontation and nationalization (1956-1960.

Psychosocial Characteristics and Obstetric Health of Women Attending a Specialist Substance Use Antenatal Clinic in a Large Metropolitan Hospital

Directory of Open Access Journals (Sweden)

Lucy Burns

2011-01-01

Full Text Available Objective. This paper reports the findings comparing the obstetrical health, antenatal care, and psychosocial characteristics of pregnant women with a known history of substance dependence (n=41 and a comparison group of pregnant women attending a general antenatal clinic (n=47. Method. Face-to-face interviews were used to assess obstetrical health, antenatal care, physical and mental functioning, substance use, and exposure to violence. Results. The substance-dependent group had more difficulty accessing antenatal care and reported more obstetrical health complications during pregnancy. Women in the substance-dependent group were more likely to report not wanting to become pregnant and were less likely to report using birth control at the time of conception. Conclusions. The profile of pregnant women (in specialised antenatal care for substance dependence is one of severe disadvantage and poor health. The challenge is to develop and resource innovative and effective multisectoral systems to educate women and provide effective care for both women and infants.

Vulval Ulcers | Rogers | Obstetrics and Gynaecology Forum

African Journals Online (AJOL)

The vulval ulcers that are seen in obstetrics and gynaecological practice in South Africa are most commonly caused by sexually transmitted diseases, especially herpes simplex infection. These ulcers have become more common due to the Human immunodeficiency virus (HIV) epidemic, and are also responsible for ...

Rhythms and Rhymes of Life. Music and Identification processes of Dutch-Moroccan youth

NARCIS (Netherlands)

Gazzah, M.

2008-01-01

Rhythms and Rhymes of Life: Music and Identification Processes of Dutch-Moroccan Youth is a comprehensive anthropological study of the social significance of music among Dutch-Moroccan youth. In the Netherlands, a Dutch-Moroccan music scene has emerged, including events and websites. Dutch-Moroccan

'A Dutch Miracle'

NARCIS (Netherlands)

Visser, Jelle; Hemerijck, Anton

1997-01-01

The Dutch polder model recently dubbed a 'success story' by Bill Clinton and Jacques Delors - plays a prominent role in current discussions about possibilities for a new 'capitalism with a social face', and appeals to experts all over the world. Just ten years ago the Swedish sociologist Goran

Determinants of health-related quality of life in the postpartum period after obstetric complications

NARCIS (Netherlands)

Prick, Babette W.; Bijlenga, Denise; Jansen, A. J. Gerard; Boers, Kim E.; Scherjon, Sicco A.; Koopmans, Corine M.; van Pampus, Marielle G.; Essink-Bot, Marie-Louise; van Rhenen, Dick J.; Mol, Ben W.; Duvekot, Johannes J.

Objective: To determine the influence of socio-demographic, clinical parameters and obstetric complications on postpartum health-related quality of life (HRQoL). Study design: We used data of three randomized controlled trials to investigate HRQoL determinants in women after an obstetric

Risks of radicalization among Turkish-Dutch young adults?

NARCIS (Netherlands)

R.H.J.M. Staring (Richard)

2014-01-01

markdownabstract__Abstract__ Young adults heading for Syria to join the jihad and the safety risks associated with their return are currently a topic of debate in the Netherlands and in many other European countries. Around 120 Dutch citizens have gone abroad to join the jihad and the Dutch

The future of the Dutch egg processing industry

NARCIS (Netherlands)

Tacken, G.M.L.; Cotteleer, G.; Horne, van P.L.M.

2003-01-01

This research examines the competitiveness of the Dutch egg products industry, as well as the consequences of tightening up the laws concerning layer poultry on the competitive position of the Dutch egg production industry. A tightening of the laws has, in fact, the effect of raising the production

The Kenyan meat sector Opportunities for Dutch agribusiness

NARCIS (Netherlands)

Bergevoet, R.H.M.; Engelen, A.

2014-01-01

This study identifies opportunities for the Dutch agribusiness sector (industry as well as research and education) in Kenyan meat value chains at all levels. It can serve as a background document for Dutch agro-food business companies as well as other stakeholders. At the moment there is increased

The acquisition of the Dutch discourse particle wel

NARCIS (Netherlands)

Hogeweg, L.; Gerrevink, R.

2015-01-01

Dutch is known for its large inventory of discourse particles. Discourse particles are very frequent and highly important in conversation. Yet, not much research has been conducted on how children acquire them. In this paper we focus on the acquisition of the Dutch discourse particle wel. In earlier

Acquisition of Morpho-Phonology: the Dutch voicing alternation

NARCIS (Netherlands)

Kerkhoff, A.O.

2007-01-01

This dissertation investigates how and when the Dutch voicing alternation is acquired. In Dutch, final neutralisation of the voice contrast (or ‘final devoicing’) leads to alternations in singular - plural pairs such as bed ~ bedden ‘bed(s)’. In such pairs, the singular always ends in a voiceless

The Dutch-Flemish PROMIS Physical Function item bank exhibited strong psychometric properties in patients with chronic pain.

Science.gov (United States)

Crins, Martine H P; Terwee, Caroline B; Klausch, Thomas; Smits, Niels; de Vet, Henrica C W; Westhovens, Rene; Cella, David; Cook, Karon F; Revicki, Dennis A; van Leeuwen, Jaap; Boers, Maarten; Dekker, Joost; Roorda, Leo D

2017-07-01

The objective of this study was to assess the psychometric properties of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function item bank in Dutch patients with chronic pain. A bank of 121 items was administered to 1,247 Dutch patients with chronic pain. Unidimensionality was assessed by fitting a one-factor confirmatory factor analysis and evaluating resulting fit statistics. Items were calibrated with the graded response model and its fit was evaluated. Cross-cultural validity was assessed by testing items for differential item functioning (DIF) based on language (Dutch vs. English). Construct validity was evaluated by calculation correlations between scores on the Dutch-Flemish PROMIS Physical Function measure and scores on generic and disease-specific measures. Results supported the Dutch-Flemish PROMIS Physical Function item bank's unidimensionality (Comparative Fit Index = 0.976, Tucker Lewis Index = 0.976) and model fit. Item thresholds targeted a wide range of physical function construct (threshold-parameters range: -4.2 to 5.6). Cross-cultural validity was good as four items only showed DIF for language and their impact on item scores was minimal. Physical Function scores were strongly associated with scores on all other measures (all correlations ≤ -0.60 as expected). The Dutch-Flemish PROMIS Physical Function item bank exhibited good psychometric properties. Development of a computer adaptive test based on the large bank is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

Magnetic resonance imaging in obstetric diagnosis.

Science.gov (United States)

Weinreb, J C; Lowe, T W; Santos-Ramos, R; Cunningham, F G; Parkey, R

1985-01-01

Five patients with abnormal pregnancies were examined with ultrasound (US) and magnetic resonance imaging (MR). Three had a malformed fetus, 1 had a molar pregnancy, and 1 had an ovarian mass. Both maternal and fetal structures were clearly shown, although fetal motion may have resulted in image degradation in some cases. The authors suggest that MR may be useful in obstetric diagnosis.

MOOC Introduction to Dutch

NARCIS (Netherlands)

den Hollander, Franciscus; Piersma, Kristien

Interview met Margriet Hidding, Birgit Lijmbach en Jeroen van Engen, medewerkers van het Talencentrum en de makers van de Massive Open Online Course (MOOC) Introduction to Dutch over het grote succes van deze cursus

Superselective uterine artery embolization for the control and prevention of obstetric hemorrhage

International Nuclear Information System (INIS)

Song Li; Tong Xiaoqiang; Wang Jian; Yang Min; Lv Yongxing; Zou Yinghua

2008-01-01

Objectives: To evaluate the efficacy of superselective uterine artery embolization for treatment and prevention of obstetric hemorrhage. Methods: Between April 2004 and December 2007, 47 consecutive patients underwent uterine artery embolization to control or prevent hemorrhage, including 20 patients for preventing hemorrhage before abortion and 27 for controlling obstetric hemorrhage. Results: Bilateral uterine artery embolization was performed in all cases except one for abnormal vascular anatomy receiving unilateral approach. Within 10 days after embolization, curettage abortion or uterine-incision delivery was done without hysterectomy, and hemorrhage during abortion was less with average of 54 ml. Conclusions: The high success rate, effectiveness and possibility of preserving reproductive function have made uterine artery embolization the technique of choice to control obstetric hemorrhage, and prophylactic embolization, can prevent hemorrhage before abortion. (authors)

Long-term maternal recall of obstetric complications in schizophrenia research.

Science.gov (United States)

Walshe, Muriel; McDonald, Colm; Boydell, Jane; Zhao, Jing Hua; Kravariti, Eugenia; Touloupoulou, Timothea; Fearon, Paul; Bramon, Elvira; Murray, Robin M; Allin, Matthew

2011-05-30

Obstetric complications (OCs) are consistently implicated in the aetiology of schizophrenia. Information about OCs is often gathered retrospectively, from maternal interview. It has been suggested that mothers of people with schizophrenia may not be accurate in their recollection of obstetric events. We assessed the validity of long term maternal recall by comparing maternal ratings of OCs with those obtained from medical records in a sample of mothers of offspring affected and unaffected with psychotic illness. Obstetric records were retrieved for 30 subjects affected with psychosis and 40 of their unaffected relatives. The Lewis-Murray scale of OCs was completed by maternal interview for each subject blind to the obstetric records. There was substantial agreement between maternal recall and birth records for the summary score of "definite" OCs, birth weight, and most of the individual items rated, with the exception of antepartum haemorrhage. There were no significant differences in the validity of recall or in errors of commission by mothers for affected and unaffected offspring. These findings indicate that several complications of pregnancy and delivery are accurately recalled by mother's decades after they occurred. Furthermore, there is no indication that mothers are less accurate in recalling OCs for their affected offspring than their unaffected offspring. When comparing women with and without recall errors, we found those with recall errors to have significantly worse verbal memory than women without such errors. Assessing the cognition of participants in retrospective studies may allow future studies to increase the reliability of their data. Copyright © 2011 Elsevier Ltd. All rights reserved.

Long-term maternal recall of obstetric complications in schizophrenia research.

LENUS (Irish Health Repository)

Walshe, Muriel

2011-05-30

Obstetric complications (OCs) are consistently implicated in the aetiology of schizophrenia. Information about OCs is often gathered retrospectively, from maternal interview. It has been suggested that mothers of people with schizophrenia may not be accurate in their recollection of obstetric events. We assessed the validity of long term maternal recall by comparing maternal ratings of OCs with those obtained from medical records in a sample of mothers of offspring affected and unaffected with psychotic illness. Obstetric records were retrieved for 30 subjects affected with psychosis and 40 of their unaffected relatives. The Lewis-Murray scale of OCs was completed by maternal interview for each subject blind to the obstetric records. There was substantial agreement between maternal recall and birth records for the summary score of "definite" OCs, birth weight, and most of the individual items rated, with the exception of antepartum haemorrhage. There were no significant differences in the validity of recall or in errors of commission by mothers for affected and unaffected offspring. These findings indicate that several complications of pregnancy and delivery are accurately recalled by mother\\'s decades after they occurred. Furthermore, there is no indication that mothers are less accurate in recalling OCs for their affected offspring than their unaffected offspring. When comparing women with and without recall errors, we found those with recall errors to have significantly worse verbal memory than women without such errors. Assessing the cognition of participants in retrospective studies may allow future studies to increase the reliability of their data.

Anaesthetic and Obstetric challenges of morbid obesity in ...

African Journals Online (AJOL)

Anaesthetic and Obstetric challenges of morbid obesity in caesarean ... in morbidly obese parturient that had caesarean delivery in a Nigerian tertiary care centre. ... This mirrors a World Health Organisation report published in the World Health ...

Obstetric outcomes after fresh versus frozen-thawed embryo transfers: A systematic review and meta-analysis.

Science.gov (United States)

Roque, Matheus; Valle, Marcello; Sampaio, Marcos; Geber, Selmo

2018-05-21

To evaluate if there are differences in the risks of obstetric outcomes in IVF/ICSI singleton pregnancies when compared fresh to frozen-thawed embryo transfers (FET). This was a systematic review and meta-analysis evaluating the obstetric outcomes in singleton pregnancies after FET and fresh embryo transfer. The outcomes included in this study were pregnancy-induced hypertension (PIH), pre-eclampsia, placenta previa, and placenta accreta. The search yielded 654 papers, 6 of which met the inclusion criteria and reported on obstetric outcomes. When comparing pregnancies that arose from FET or fresh embryo transfer, there was an increase in the risk of obstetric complications in pregnancies resulting from FET when compared to those emerging from fresh embryo transfers in PIH (aOR 1.82; 95% CI 1.24-2.68), pre-eclampsia (aOR 1.32, 95% CI 1.07, 1.63), and placenta accreta (aOR 3.51, 95% CI 2.04-6.05). There were no significant differences in the risk between the FET and fresh embryo transfer groups when evaluating placenta previa (aOR 0.70; 95% CI 0.46-1.08). The obstetric outcomes observed in pregnancies arising from ART may differ among fresh and FET cycles. Thus, when evaluating to perform a fresh embryo transfer or a freeze-all cycle, these differences found in obstetric outcomes between fresh and FET should be taken into account. The adverse obstetric outcomes after FET found in this study emphasize that the freeze-all policy should not be offered to all the patients, but should be offered to those with a clear indication of the benefit of this strategy.

Future Career Plans and Practice Patterns of Canadian Obstetrics and Gynaecology Residents in 2011.

Science.gov (United States)

Burrows, Jason; Coolen, Jillian

2016-01-01

The practice patterns of Obstetricians and Gynaecologists continue to evolve with each new generation of physicians. Diversifying subspecialties, changes in resident duty hours, job market saturation, and desire for work-life balance are playing stronger roles. Professional practice direction and needs assessment may be aided by awareness of future Obstetrics and Gynaecology physician career plans and expectations. The objective of this study was to determine the expected career plans and practice patterns of Canadian Obstetrics and Gynaecology residents following residency. The SOGC Junior Member Committee administered its third career planning survey to Canadian Obstetrics and Gynaecology residents electronically in December 2011. The data collected was statistically analyzed and compared to previous surveys. There were 183 responses giving a response rate of 43%. More than one half of all residents were considering postgraduate training (58%). Projected practice patterns included: 84% maintaining obstetrical practice, 60% locuming, and 50% job-sharing. The majority of residents expected to work in a 6 to 10 person call group (48%), work 3 to 5 call shifts per month (72%), work 41 to 60 hours weekly (69%), and practise in a city with a population greater than 500 000 (45%). Only 18% of residents surveyed were in favour of streaming residency programs in Obstetrics and Gynaecology. Canadian resident career plan and expected practice pattern assessment remains an important tool for aiding in resource allocation and strategic development of care and training in Obstetrics and Gynaecology in Canada. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

Competition in the Dutch hospital sector : an analysis of health care volume and cost

NARCIS (Netherlands)

Krabbe-Alkemade, Y. J F M; Groot, T. L C M; Lindeboom, M.

2017-01-01

This paper evaluates the impact of market competition on health care volume and cost. At the start of 2005, the financing system of Dutch hospitals started to be gradually changed from a closed-end budgeting system to a non-regulated price competitive prospective reimbursement system. The gradual

Obstetric Violence, Another Form of Violence Against Women. The Tenerife Case

OpenAIRE

Rodríguez Ramos, Paulo Adrían; Aguilera Ávila, Laura

2017-01-01

IntroductionThe subject of this study is Obstetric Violence (OV). OV is understood as the different ways in which pregnant women, or those who are going into labor, are controlled and oppressed. OV may be considered as another type of gender-based violence because its aim is to control and oppress women. Additionally, OV could be considered as institutional and symbolic violence.ObjectivesThe aim of this study is to discover whether new mothers in Tenerife are being subject to Obstetric Viole...

The traditional healer in obstetric care: A persistent wasted opportunity in maternal health.

Science.gov (United States)

Aborigo, Raymond Akawire; Allotey, Pascale; Reidpath, Daniel D

2015-05-01

Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Between local governments and communities: Knowledge exchange and mutual learning in Dutch-Moroccan and Dutch-Turkish municipal partnerships

OpenAIRE

van Ewijk, E.

2013-01-01

This PhD dissertation focuses on mutual learning processes of governmental and non-governmental actors involved in Dutch-Moroccan and Dutch-Turkish municipal partnerships in the period 2007-2011. These partnerships aim at strengthening local governance in Morocco and Turkey as well as in the Netherlands. The research focuses on five case studies and indicate the partnerships lead to important forms of learning at both sides, including strengthening service delivery and working in multi-actor ...

The methodological quality of economic evaluation studies in obstetrics and gynecology: a systematic review

NARCIS (Netherlands)

Vijgen, Sylvia M. C.; Opmeer, Brent C.; Mol, Ben Willem J.

2013-01-01

We evaluated the methodological quality of economic evaluation studies in the field of obstetrics and gynecology published in the last decade. A MEDLINE search was performed to find economic evaluation studies in obstetrics and gynecology from the years 1997 through 2009. We included full economic

New rate structure of the Dutch natural gas trading company Gasunie

International Nuclear Information System (INIS)

Koevoet, H.

1999-01-01

Starting January 1, 2000, many of Gasunie's large-scale consumers will have to deal with a new rate structure: the CDS (Dutch abbreviation for Commodity Services System). Unlike in the old zone system, the consumption profile is of great importance in the CDS. Those who must heat large spaces have a particular interest in sizing up the consequences of the CDS

Present state and perspectives of RIA in obstetrics and gynecology

Energy Technology Data Exchange (ETDEWEB)

Talas, M; Fingerova, H [Palackeho Univ., Olomouc (Czechoslovakia). Lekarska Fakulta

1979-01-01

A survey is presented of RIA methods introduced by the authors in their laboratory in the course of the last eight years. The results obtained by these methods in various physiological and pathological states are evaluated. The authors point to the possibilities of effective use of RIA for diagnostic purposes in obstetrics and gynecology taking into account also economic and organizational aspects. The most important trends of the use of RIA are accentuated not only in gynecological endocrinology and obstetrics but also in some other related fields, especially in the diagnosis and treatment of malignant diseases.

Present state and perspectives of RIA in obstetrics and gynecology

International Nuclear Information System (INIS)

Talas, M.; Fingerova, H.

1979-01-01

A survey is presented of RIA methods introduced by the authors in their laboratory in the course of the last eight years. The results obtained by these methods in various physiological and pathological states are evaluated. The authors point to the possibilities of effective use of RIA for diagnostic purposes in obstetrics and gynecology taking into account also economic and organizational aspects. The most important trends of the use of RIA are accentuated not only in gynecological endocrinology and obstetrics but also in some other related fields, especially in the diagnosis and treatment of malignant diseases. (author)

Exhalation velocity of radon-222 of Dutch building materials and the influence of paint systems

International Nuclear Information System (INIS)

Dijk, W. van; Jong, P. de

1989-02-01

In order to achieve a better insight concerning the source terms of radon in the Dutch dwelling in the framework of the RENA-programme an investigation has been performed into the exhalation velocity of radon-222 from building materials. From this investigation it turned out that the ventilation factor does not have any influence upon the exhalation velocity, neither an influence of alteration of air pressure could be demonstrated. The influence of air humidity upon the exhalation velocity showed a twofold picture; for gypsum a linear increase of the exhalation velocity with vapour pressure was found, while for concrete a linear decrease with vapour pressure was observed. Further it has been investigated in how far paint systems diminish the exhalation velocity of the Rn-222 from gypsum and concrete. Acryl paints, mostly used in the Dutch dwelling, did not show a decrease of the exhalation velocity and structure paints did even cause an increase of the exhalation velocity. Other types of paint based on chlorous rubber, epoxy resins and poly-urethane, in contrast, showed a clear reduction. From these those based on poly-urethane showed the largest reduction (60-75%) at a double sided treatment of the wall. With the help of a mathematical modelling of the exhalation estimations have been made of the exhalation velocity of Rn-222 at single sided treatment of a wall and for the exhalation velocity of Rn-220. For the fore mentioned poly-urethane-paints this yelds, at an estimate, a reduction of respectively 90-95% and 100%. (author). 40 refs.; 15 figs.; 8 tabs

Super selective transcatheter angiographic embolization: an effective and prophylactic treatment for massive obstetric haemorrhage

International Nuclear Information System (INIS)

Zhou Yiming; Zhai Renyou; Qian Xiaojun; Wei Baojie; Gao Kun; Zhang Shilong; Liu Jinmei; Zhang Qiuhong; Jiang Lei

2008-01-01

Objective: To discuss the effect and safety of transcatheter angiographic embolization (TAE)for managing massive obstetric haemorrhage. Methods: 17 cases of obstetric massive haemorrhage or with haemorrhage tendency were treated with TAE. Among them 14 cases had haemorrhage already, including 10 cases after abortion, caesarean section or normal labor and other 4 of hydatidiform mole. 3 cases with obstetric haemorrhage tendency included 2 cases of placenta praevia and 1 case of cervical pregnancy. Selective catheterization into bilateral uterine arteries or internal iliac arteries for DSA, showed the cause and location of the haemorrhage and then embolized with gelfoam sponge chips (1-3 mm) or Polyvinyl Alcohol(PVA); and part of the cases with MTX through uterine arterial perfusion. Results: The successful rate of catheterization was 100%. The achievement in 14 cases showed no active haemorrhage immediately after the procedure and no vaginal bleeding after 1-5 days. In 3 prophylactic cases before abortion or uterine curettage, obstetric massive haemorrhage occurred in 1 case, but not so in other 2 cases. Conclusions: TAE is an effective treatment for obstetric massive haemorrhage, with the advantages of minimal trauma, fast and definite treating effect and less complications. Prophylactical application for high risk patients can reduce the bleeding and mortality. (authors)

Women in leadership positions within obstetrics and gynecology: does the past explain the present?

Science.gov (United States)

Baecher-Lind, Laura

2012-12-01

To determine whether the proportion of leadership positions in obstetrics and gynecology held by women is consistent with expectations based on the proportion of women entering residency at the time of current leaders. Leadership positions were considered as department chairs affiliated with the Council of University Chairs of Obstetrics and Gynecology, editors of the 20 obstetrics and gynecology journals with the highest impact factors [corrected],and presidents of influential professional societies. Publically available data were accessed to determine sex and the year of medical school graduation for each individual holding each leadership position, as well as to determine the number of men and women entering residency in obstetrics and gynecology per year. Actual and expected proportions of leadership positions held by women were compared using χ² tests. Women should hold 71 of the total 194 leadership positions based on the proportion of women entering residency during the mean graduation year among leaders. Women actually hold 41 of these leadership positions (21.1%; Pwomen should hold 28 of these 74 leadership positions. Women actually hold 20 of the leadership positions from this subset (27.0%; P=.05). Women are underrepresented in leadership positions in obstetrics and gynecology, and this cannot be explained by historical sex imbalances among physicians entering our specialty.

Dutch Building Decree

NARCIS (Netherlands)

Scholten, N.P.M.

2000-01-01

On the 1 October 1992 a change in the Dutch building legislation took effect: the revised Housing Act, the Building Decree and the technical documents related to this legislation came into force. This publication contains an English translation of the Building Decree. In order to give an idea of the

Experiences and impact of mistreatment and obstetric violence on women during childbearing: a systematic review protocol.

Science.gov (United States)

McGarry, Julie; Hinsliff-Smith, Kathryn; Watts, Kim; McCloskey, Paula; Evans, Catrin

2017-03-01

The aim of this review is to synthesize the best available evidence on the experiences of mistreatment and/or obstetric violence in women. Specifically, the objective is to explore, from a woman's point of view, the impacts and consequences of mistreatment and/or obstetric violence during childbearing. The review question is: "What are the experiences and impact of mistreatment and obstetric violence on women during the active period of childbearing?"

Globalisation of the National Judiciary and the Dutch Constitution

Directory of Open Access Journals (Sweden)

Elaine Mak

2013-03-01

Full Text Available This article examines the changing practices of the Dutch highest courts, the Hoge Raad and the Afdeling bestuursrechtspraak van de Raad van State, under the influence of globalisation, and the constitutional implications of this development. The increasing intertwinement of legal systems and the increasing possibilities for judges to interact with courts in foreign jurisdictions have stimulated the consideration of foreign legislation and case law in judicial decision-making in individual cases. An empirical study clarifies how the Dutch judges perceive the usefulness of legal comparisons in this context and how foreign law is used in deliberations and judgments. The constitutional implications of the changing practices of the courts are analysed in light of three aspects of the constitutional normative framework for judicial decision-making: the democratic justification of judicial decisions; legal tradition and the nature of cases; and the effectiveness and efficiency of judicial decision-making.

Partograph utilization and associated factors among obstetric care ...

African Journals Online (AJOL)

% of maternal deaths which can be reduced by proper utilization of partograph during labor. Methods: An Institution based cross-sectional study was conducted in June, 2013 on 403 obstetric care providers. A pre-test- ed and structured ...

Basso continuo sources from the Dutch Republic c. 1620-c1790

NARCIS (Netherlands)

Cok, Kathryn Meriel

2011-01-01

The results presented in this dissertation demonstrate the generous contribution that the Dutch Republic has made to the genre of basso continuo, including a survey of twenty-six Dutch sources from the 17th and 18th centuries. Focus has been made on the written record of the practice in the Dutch

Economic Impact of the Dutch Gas Hub Strategy on the Netherlands

International Nuclear Information System (INIS)

Harris, D.; Bazelon, C.; Humphreys, B.; Dickson, P.

2010-09-01

Since the discovery of the Groningen gas field in 1959, the Netherlands has been a key player in the European gas market. The Netherlands has built up a large onshore and offshore Exploration and Production sector, it has a highly developed gas transmission and distribution network, and is a major exporter of gas to other EU Member States. The Netherlands has considerable expertise in all parts of the gas supply chain, and is a world centre for Research and development in natural gas supply and use. More recently construction has begun on terminals to allow the import of Liquid Natural Gas to the Netherlands. However, Dutch gas reserves are now in decline, and the Netherlands will become a net importer of gas around 2025. The Dutch government wishes to capitalise on the existing industry and skills and sustain the Netherlands' place in the European gas industry beyond the life of the existing gas fields. In November 2009 the Minister of Economic Affairs published a paper describing the strategy of turning the Netherlands into a 'Gas Hub' or 'gas roundabout' for north-west Europe. The Dutch government intends that the gas hub would capitalise on the existing skills and industry, increase competition and security of supply in the Dutch gas market, create employment and make a significant contribution to the Dutch economy. The Dutch Ministry of Economic Affairs, Agriculture and Innovation has commissioned The Brattle Group to perform an analysis of the economic impact of the gas hub concept. The study has several aims including: To analyse the current contribution of the Dutch gas sector to the economy; To assess the Strengths, Weaknesses, Opportunities and Threats associated with the gas hub strategy; To quantify the benefits of the gas hub strategy to the Dutch economy. Note that the aim of the study is to define in more detail what a successful Dutch gas hub strategy would look like, to assess the strengths and weakness of the Dutch gas sector in achieving a

Obstetric and perinatal outcome in teenage pregnancies

African Journals Online (AJOL)

2013-09-02

Sep 2, 2013 ... subjects gave birth in the Department of Obstetrics and Gynaecology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia, a referral ... Factors that may contribute to this problem are lack of education and information .... be relevant to the origins of some child mental health disorders. Our study ...

Subspecialty Influence on Scientific Peer Review for an Obstetrics and Gynecology Journal With a High Impact Factor.

Science.gov (United States)

Parikh, Laura I; Benner, Rebecca S; Riggs, Thomas W; Hazen, Nicholas; Chescheir, Nancy C

2017-02-01

To evaluate whether quality of peer review and reviewer recommendation differ based on reviewer subspecialty in obstetrics and gynecology and to determine the role of experience on reviewer recommendation. We performed a retrospective cohort study of reviews submitted to Obstetrics & Gynecology between January 2010 and December 2014. Subspecialties were determined based on classification terms selected by each reviewer and included all major obstetrics and gynecology subspecialties, general obstetrics and gynecology, and nonobstetrics and gynecology categories. Review quality (graded on a 5-point Likert scale by the journal's editors) and reviewer recommendation of "reject" were compared across subspecialties using χ, analysis of variance, and multivariate logistic regression. There were 20,027 reviews from 1,889 individual reviewers. Reviewers with family planning subspecialty provided higher-quality peer reviews compared with reviewers with gynecology only, reproductive endocrinology and infertility, gynecologic oncology, and general obstetrics and gynecology specialties (3.61±0.75 compared with 3.44±0.78, 3.42±0.72, 3.35±0.75, and 3.32±0.81, respectively, Ppeer reviews (greater than 195) compared with the lowest quintile (one to seven) (adjusted OR 2.85 [2.60-3.12]). Peer review quality differs based on obstetrics and gynecology subspecialty. Obstetrics and gynecology subspecialty and reviewer experience have implications for manuscript rejection recommendation. Reviewer assignment is pivotal to maintaining a rigorous manuscript selection process.

Transarterial embolization for the treatment of massive bleeding in gynecologic and obstetric emergencies: a single center experience.

Science.gov (United States)

Hongsakul, Keerati; Songjamrat, Apiradee; Rookkapan, Sorracha

2014-08-01

Delayed treatment of the massive bleeding in gynecologic and obstetric conditions can cause high morbidity and mortality. The aim of this study is to assess the angiographic findings and outcomes of transarterial embolization in cases of massive hemorrhage from underlying gynecological and obstetrical conditions. This is a retrospective study of 18 consecutive patients who underwent transarterial embolization of uterine and/or hypogastric arteries due to massive bleeding from gynecological and obstetrical causes from January 2006 to December 2011. The underlying causes of bleeding, angiographic findings, technical success rates, clinical success rates, and complications were evaluated. Massive gynecological and obstetrical bleeding occurred in 12 cases and 6 cases, respectively. Gestational trophoblastic disease was the most common cause of gynecological bleeding. The most common cause of obstetrical hemorrhage was primary post-partum hemorrhage. Tumor stain was the most frequent angiographic finding (11 cases) in the gynecological bleeding group. The most common angiographic findings in obstetrical patients were extravasation (2 cases) and pseudoaneurysm (2 cases). Technical and final clinical success rates were found in all 18 cases and 16 cases. Collateral arterial supply, severe metritis, and unidentified cervical laceration were causes of uncontrolled bleeding. Only minor complications occurred, which included pelvic pain and groin hematoma. Percutaneous transarterial embolization is a highly effective and safe treatment to control massive bleeding in gynecologic and obstetric emergencies.

Cultural Perspectives on Peer Conflicts in Multicultural Dutch Child Care Centres

Science.gov (United States)

Rourou, Amina; Singer, Elly; Bekkema, Nienke; De Haan, Dorian

2006-01-01

In this paper we discuss a study of cultural perspectives on peer conflicts in multicultural child care centres. On the level of child behaviour we did not find differences between native Dutch. Moroccan-Dutch and Antillean-Dutch children with regard to occurrence, duration and actions to solve peer conflicts. On the level of mother' opinions…

Green growth: innovative capacity of sme's in the Dutch Greenhouse Horticulture Industry

NARCIS (Netherlands)

dr. MBA S.J.M. (Saskia) Harkema; H.J. (Henk) Schout

2011-01-01

The Dutch greenhouse horticultural industry is characterized by world leadership in high-tech innovation. The dynamics of this playing field are innovation in production systems and automation, reduction in energy consumption and sharing limited space. However, international competitive advantage of

Green networks: innovative capacity of sme's in the Dutch Greenhouse Horticulture Industry

NARCIS (Netherlands)

H.J. (Henk) Schout; dr. MBA S.J.M. (Saskia) Harkema

2011-01-01

The Dutch greenhouse horticulture industry is characterized by world leadership in high-tech innovation. The dynamics of this playing field are innovation in production systems and automation, reduction in energy consumption and sharing limited space. However, international competitive advantage of

National Identification of Dutch Youth: An Exploratory Study

Science.gov (United States)

Oppenheimer, Louis

2011-01-01

246 Dutch participants aged 8, 10, 12, 14, and 16 years were presented with the Strength of Identification Scale (SoIS; Barrett, 2007) and the National Identity scale based on Cultural and Historical achievements (NICH; derived from the NATID, Keillor & Hult, 1999). The study aimed to examine the extent and nature of Dutch children and…

The Comparability of English, French and Dutch Scores on the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F): An Assessment of Differential Item Functioning in Patients with Systemic Sclerosis

Science.gov (United States)

Kwakkenbos, Linda; Willems, Linda M.; Baron, Murray; Hudson, Marie; Cella, David; van den Ende, Cornelia H. M.; Thombs, Brett D.

2014-01-01

Objective The Functional Assessment of Chronic Illness Therapy- Fatigue (FACIT-F) is commonly used to assess fatigue in rheumatic diseases, and has shown to discriminate better across levels of the fatigue spectrum than other commonly used measures. The aim of this study was to assess the cross-language measurement equivalence of the English, French, and Dutch versions of the FACIT-F in systemic sclerosis (SSc) patients. Methods The FACIT-F was completed by 871 English-speaking Canadian, 238 French-speaking Canadian and 230 Dutch SSc patients. Confirmatory factor analysis was used to assess the factor structure in the three samples. The Multiple-Indicator Multiple-Cause (MIMIC) model was utilized to assess differential item functioning (DIF), comparing English versus French and versus Dutch patient responses separately. Results A unidimensional factor model showed good fit in all samples. Comparing French versus English patients, statistically significant, but small-magnitude DIF was found for 3 of 13 items. French patients had 0.04 of a standard deviation (SD) lower latent fatigue scores than English patients and there was an increase of only 0.03 SD after accounting for DIF. For the Dutch versus English comparison, 4 items showed small, but statistically significant, DIF. Dutch patients had 0.20 SD lower latent fatigue scores than English patients. After correcting for DIF, there was a reduction of 0.16 SD in this difference. Conclusions There was statistically significant DIF in several items, but the overall effect on fatigue scores was minimal. English, French and Dutch versions of the FACIT-F can be reasonably treated as having equivalent scoring metrics. PMID:24638101

Seasonal and long-term changes in pH in the Dutch coastal zone

Directory of Open Access Journals (Sweden)

P. Provoost

2010-11-01

Full Text Available Recent observations and modelling studies suggest that biogeochemical changes can mask atmospheric CO₂-induced pH decreases. Data collected by the Dutch monitoring authorities in different coastal systems (North Sea, Wadden Sea, Ems-Dollard, Eastern Scheldt and Scheldt estuary since 1975 provide an excellent opportunity to test whether this is the case in the Dutch coastal zone. The time-series were analysed using Multi-Resolution Analysis (MRA which resulted in the identification of system-dependent patterns on both seasonal and intra-annual time scales. The observed rates of pH change greatly exceed those expected from enhanced CO₂ uptake, thus suggesting that other biogeochemical processes, possibly related to changes in nutrient loading, can play a dominant role in ocean acidification.

Equality on Different Terms: The Case of Dutch Hindu Schools

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Merry, Michael S.; Driessen, Geert

2012-01-01

In this article the authors examine the reasons for the establishment of Hindu schools in the Netherlands and how the Dutch system of education facilitates these and other voluntarily separate schools. In particular, the authors explore the manner in which Hindu schools aim to cultivate and sustain attachments to their own group through a…

Dutch Wholesale Power Market Review 2002. Executive Summary

International Nuclear Information System (INIS)

Vollebregt, T.; Rusch, H.

2002-01-01

Chapter 1 provides a background to the Dutch power market, covering generation, transmission, distribution, supply, and laws and regulations. Chapter 2 reviews the key market events during 2001 and early 2002, providing analysis and background on an important and tumultuous period in the Dutch market. Chapter 3 explains the structure and timing of the key market mechanisms (Amsterdam Power Exchange, interconnector capacity auctions, TenneT 15-minute balancing market). Chapter 4 briefly reviews fuel price developments and discusses their impact on the costs of generation. Chapter 5 contains a detailed review of the traded Dutch power markets (APX, OTC, interconnection), including the linkages between these markets and an analysis of arbitrage opportunities

QUALIS EVALUATION OF MEDICINE III: ANALYSIS OF ANESTHESIOLOGY AND GYNECOLOGY AND OBSTETRICS JOURNALS.

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Calderon, Iracema de Mattos Paranhos

2015-01-01

To know the current publication of Anesthesiology and Obstetrics and Gynecology subareas, to support the updating of Qualis Journals criteria in these specific subareas. Cross-sectional, descriptive study in which was evaluated in quantitatively and qualitatively way the bibliographic production of Anesthesiology and Obstetrics and Gynecology subareas, from January 2010 to December 2012. Were investigated the values ​​of the impact factor; calculated (i) the number (n) and the percentage of journals in each stratum Qualis A1, A2, B1, B2, B3, B4 and B5, and (ii) the median values ​​and their extreme limits (minimum values ​​and maximum) and quartiles (p25; p50; p75; p90) of the impact factors in the different strata. The bibliographic production of the three-year period 2010-2012 was published in 69 journals in Anesthesiology subarea and in 345 in Gynecology and Obstetrics. In Anesthesiology, 44% were within the limits of impact factor of superior A1, A2 and B1; in Obstetrics and Gynecology, 42.4% were in those limits and strata. Despite lagging behind by international standards, publications of Anesthesiology and Obstetrics and Gynecology showed tendency to improve the quality. In these sub-areas, the median of journals impact factor is beyond the limits defined by the area in the last assessment. Therefore, it must be reconsidered new indicators to assess this aspect. Conhecer a publicação atual das subáreas Anestesiologia e Ginecologia e Obstetrícia, para subsidiar a atualização dos critérios Qualis-periódicos, específicos dessas subáreas. Estudo de corte transversal, descritivo, onde avaliou-se, de modo quantitativo e qualitativo, a produção bibliográfica das subáreas Anestesiologia e Ginecologia e Obstetrícia, no período de janeiro de 2010 a dezembro de 2012. Foram definidos os valores do fator de impacto das revistas; foram calculados (i) o número (n) e percentual de periódicos em cada um dos estratos Qualis - A1, A2, B1, B2, B3

Inequity in contraceptive care between refugees and other migrant women?: a retrospective study in Dutch general practice.

Science.gov (United States)

Raben, Liselotte A D; van den Muijsenbergh, Maria E T C

2018-01-17

Female refugees are at high risk of reproductive health problems including unmet contraceptive needs. In the Netherlands, the general practitioner (GP) is the main entrance to the healthcare system and plays a vital role in the prescription of contraceptives. Little is known about contraceptive care in female refugees in primary care. To get insight into GP care related to contraception in refugees and other migrants compared with native Dutch women. A retrospective descriptive study of patient records of refugees, other migrants and native Dutch women was carried out in five general practices in the Netherlands. The prevalence of discussions about contraception and prescriptions of contraceptives over the past 6 years was compared in women of reproductive age (15-49 years). In total, 104 refugees, 58 other migrants and 162 native Dutch women were included. GPs in our study (2 male, 3 female) discussed contraceptives significantly less often with refugees (51%) and other migrants (66%) than with native Dutch women (84%; P Dutch women (79%; P Dutch women (4% respectively 4%). Contraceptives were significantly less often discussed with and prescribed to refugees and other migrant women compared with native Dutch women. More research is needed to elicit the reproductive health needs and preferences of migrant women regarding GP's care and experiences in discussing these issues. Such insights are vital in order to provide equitable reproductive healthcare to every woman regardless of her background. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Amniotic band-like structures | Govender | Obstetrics and ...

African Journals Online (AJOL)

Intra-amniotic band-like structures are seen fairly commonly on routine obstetric scans, especially during the first and second trimesters of pregnancy. It is important to establish the cause for such findings in order to determine their clinical significance and to assess prognosis. The vast majority of band-like structures are ...

Relationships of nuclear, architectural and International Federation of Gynecology and Obstetrics grading systems in endometrial cancer.

Science.gov (United States)

Toptaş, Tayfun; Peştereli, Elif; Bozkurt, Selen; Erdoğan, Gülgün; Şimşek, Tayup

2018-03-01

To examine correlations among nuclear, architectural, and International Federation of Gynecology and Obstetrics (FIGO) grading systems, and their relationships with lymph node (LN) involvement in endometrioid endometrial cancer. Histopathology slides of 135 consecutive patients were reviewed with respect to tumor grade and LN metastasis. Notable nuclear atypia was defined as grade 3 nuclei. FIGO grade was established by raising the architectural grade (AG) by one grade when the tumor was composed of cells with nuclear grade (NG) 3. Correlations between the grading systems were analyzed using Spearman's rank correlation coefficients, and relationships of grading systems with LN involvement were assessed using logistic regression analysis. Correlation analysis revealed a significant and strongly positive relationship between FIGO and architectural grading systems (r=0.885, p=0.001); however, correlations of nuclear grading with the architectural (r=0.535, p=0.165) and FIGO grading systems (r=0.589, p=0.082) were moderate and statistically non-significant. Twenty-five (18.5%) patients had LN metastasis. LN involvement rates differed significantly between tumors with AG 1 and those with AG 2, and tumors with FIGO grade 1 and those with FIGO grade 2. In contrast, although the difference in LN involvement rates failed to reach statistical significance between tumors with NG 1 and those with NG 2, it was significant between NG 2 and NG 3 (p=0.042). Although all three grading systems were associated with LN involvement in univariate analyses, an independent relationship could not be established after adjustment for other confounders in multivariate analysis. Nuclear grading is significantly correlated with neither architectural nor FIGO grading systems. The differences in LN involvement rates in the nuclear grading system reach significance only in the setting of tumor cells with NG 3; however, none of the grading systems was an independent predictor of LN involvement.

Obstetric outcome in pregnant women subjected to domestic violence.

Science.gov (United States)

Ameh, N; Shittu, S O; Abdul, M A

2009-06-01

To determine the prevalence of domestic violence and its relationship to adverse obstetric outcomes amongst pregnant women who deliver at a tertiary level hospital in Zaria, Nigeria. A cross-sectional study involving 310 women who delivered at the labour ward. Questionnaires were administered to parturient women. Details of their socio-demographic characteristics and obstetric outcome were compiled and the relationship to experiences of domestic violence studied. The prevalence of domestic violence was 28.4%. There was positive relationship between domestic violence during pregnancy, non-supervision of pregnancy and poor attendances to antenatal clinic (pviolence, and complications of labour and neonatal outcome (p>0.05). The prevalence of domestic violence in pregnancy is high in this environment. Poor attendances to the antenatal clinic is a significant association.

The critical role of supervision in retaining staff in obstetric services: a three country study.

Directory of Open Access Journals (Sweden)

Eilish McAuliffe

Full Text Available Millennium Development Goal (MDG 5 commits us to reducing maternal mortality rates by three quarters and MDG 4 commits us to reducing child mortality by two-thirds between 1990 and 2015. In order to reach these goals, greater access to basic emergency obstetric care (EmOC as well as comprehensive EmOC which includes safe Caesarean section, is needed.. The limited capacity of health systems to meet demand for obstetric services has led several countries to utilize mid-level cadres as a substitute to more extensively trained and more internationally mobile healthcare workers. Although this does provide greater capacity for service delivery, concern about the performance and motivation of these workers is emerging. We propose that poor leadership characterized by inadequate and unstructured supervision underlies much of the dissatisfaction and turnover that has been shown to exist amongst these mid-level healthcare workers and indeed health workers more generally. To investigate this, we conducted a large-scale survey of 1,561 mid-level cadre healthcare workers (health workers trained for shorter periods to perform specific tasks e.g. clinical officers delivering obstetric care in Malawi, Tanzania, and Mozambique. Participants indicated the primary supervision method used in their facility and we assessed their job satisfaction and intentions to leave their current workplace. In all three countries we found robust evidence indicating that a formal supervision process predicted high levels of job satisfaction and low intentions to leave. We find no evidence that facility level factors modify the link between supervisory methods and key outcomes. We interpret this evidence as strongly supporting the need to strengthen leadership and implement a framework and mechanism for systematic supportive supervision. This will promote better job satisfaction and improve the retention and performance of obstetric care workers, something which has the potential

The Dutch Are Missing in the American Curriculum

Science.gov (United States)

Claunch, Ann

2009-01-01

The Dutch are missing in any U.S. history textbook, in the content standards, and in the nationally endorsed curriculum. Outside of New York State history classes, there is almost no mention of the Dutch influence in early 17th-century America. Fleeting references to the Netherlands as a staging area for the Pilgrims' famous "Mayflower"…

CESAM: The CCSO annual model of the Dutch economy

NARCIS (Netherlands)

Jongbloed, Benjamin W.A.; Kuipers, S.K.; Kuper, G.H.; Sterken, E.

1990-01-01

This paper presents CESAM, a macroeconometric model of the Dutch economy based on annual data. CESAM can be characterized as a Keynesian expenditure model including a neoclassical production model and a post-Keynesian financial model. This characterization holds for most of the Dutch

Training in motivational interviewing in obstetrics: a quantitative analytical tool.

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Lindhardt, Christina L; Rubak, Sune; Mogensen, Ole; Hansen, Helle P; Lamont, Ronald F; Jørgensen, Jan S

2014-07-01

To examine whether a 3-day training course in motivational interviewing, which is an approach to helping people to change, could improve the communication skills of obstetric healthcare professionals in their interaction with obese pregnant women. Intervention study. The Region of Southern Denmark. Eleven obstetric healthcare professionals working with obese pregnant women underwent a 3-day course in motivational interviewing techniques and were assessed before and after training to measure the impact on their overall performance as well as the effect on specific behavioral techniques observed during interviews. With a few exceptions, the participants changed their behavior appropriate to the motivational interviewing technique. The participants made more interventions towards the principles of motivational interviewing (adherent and nonadherent interventions). Furthermore, the participants asked fewer closed and more open questions before training in motivational interview. In the assessment of proficiency and competency, most of the participants scored higher after the training in motivational interviewing. Training in motivational interviewing improves healthcare professionals' proficiency and competency when communicating with obese pregnant women, albeit that the effect was not universal. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

A Metrical Theory of Stress and Destressing in English and Dutch

NARCIS (Netherlands)

Kager, R.W.J.

1989-01-01

The topic of this study is word stress, more specifically the relation between rules of stress and destressing within the framework of metrical phonology. Our claims will be largely based on in-depth analyses of two word stress systems: those of English and Dutch. We intend to offer a

HIV-TB Coinfection among 57 Million Pregnant Women, Obstetric Complications, Alcohol Use, Drug Abuse, and Depression.

Science.gov (United States)

Fernandez, Dorian; Salami, Imoleayo; Davis, Janelle; Mbah, Florence; Kazeem, Aisha; Ash, Abreah; Babino, Justin; Carter, Laquiesha; Salemi, Jason L; Spooner, Kiara K; Olaleye, Omonike A; Salihu, Hamisu M

2018-01-01

HIV and tuberculosis represent diseases of major public health importance worldwide. Very little is known about HIV-TB coinfection among pregnant women, especially from industrialized settings. In this study, we examined the association between TB, HIV, and HIV-TB coinfection among pregnant mothers and obstetric complications, alcohol use, drug abuse, and depression. We examined inpatient hospital discharges in the United States from January 1, 2002, through December 31, 2014. We employed multivariable survey logistic regression to generate adjusted estimates for the association between infection status and study outcomes. We analyzed approximately 57 million records of pregnant women and their delivery information. HIV-TB coinfection was associated with the highest risks for several obstetric complications, alcohol use, and drug abuse. The risk for alcohol abuse was more than twice as high among HIV-monoinfected as compared to TB-monoinfected mothers. That risk gap more than doubled with HIV-TB coinfection. Both HIV-monoinfected and HIV-TB coinfected mothers experienced similarly increased risks for depression. Mothers with HIV-TB coinfection experienced relatively heightened risks for obstetric complications, alcohol use, and drug abuse. The findings of this study underscore the importance of augmenting and enhancing social and structural support systems for HIV-TB coinfected pregnant women.

Assessment of current Dutch energy transition policy instruments for the existing housing stock

International Nuclear Information System (INIS)

Tambach, Milly; Hasselaar, Evert; Itard, Laure

2010-01-01

This research assesses to what extent current Dutch energy transition policy instruments for the existing housing stock can fulfil local executive actors' needs and instigate adoption of energy efficiency measures by them. This is done by studying energy policy instruments for the existing housing stock in the Netherlands and in other European countries, and by an empirical research, which analyses barriers and needs of local executive actors. We found that, despite current Dutch energy transition policy instruments for the existing housing stock seem to fulfil local executive actors' needs to a large extent, complementary policy instruments are needed to stimulate and pressure the incumbent renovation regime. A long-term oriented financial rewarding system is needed to build up a structural market for the deployment of renewables, to increase the number of specialist jobs in the building sector, and to stimulate the development of integrated, standardized, building components. Furthermore, a long-term oriented financial rewarding system for energy efficiency investments in housing renovation projects, and a low VAT rate applied to energy efficient renovation measures, are needed. Finally, enforcement possibilities and sanctions (fines) should become an integrative part of Dutch energy certification regulation to make the certificate become part of a value chain.

Dutch chemical producers pledge emissions cuts

International Nuclear Information System (INIS)

Chynoweth, E.; Schoenmakers, J.

1993-01-01

Dutch chemical producers have negotiated a long-term agreement with government ministries to reduce emissions of a wide range of chemicals. Industry association Vereniging van de Nederlandse Chemische Industrie (VNCI; Leidschendam) says implementing the commitment will cost companies Dfl 10 billion ($5.4 billion) between 1993 and 2000. VNCI technical director Wim Quik welcomes the accord, which he describes as a management contract, saying, Rather than have legislation, there is a certain adjustment available. Peter Santen, managing director of midsized chemicals player Cindu Chemicals (Uithoorn, the Netherlands) voices some concern about the details of the accord, but adds, we are flexible in trying to agree with the contents of the covenant [it] is better than having new rules from law. The Dutch government, traditionally eager for consensus, has struck a number of such deals with Dutch industries - including packaging, metal, and tire - to reduce emissions and set up environmental management programs. The effort is based on the government's National Environmental Policy Plans - NMP and NMP Plus. Targets for emissions reduction by the chemical industry were provided by a government-funded environmental research institute

Young Asian Dutch constructing Asianness: Understanding the role of Asian popular culture

NARCIS (Netherlands)

Kartosen, R.A.

2016-01-01

This doctoral thesis is about young Asian Dutch, panethnic Asian identities and identifications, and Asian/Asian Dutch popular culture. It addresses several pressing questions, including: why do young Asian Dutch, who were born and/or raised in the Netherlands, identify as Asian and construct Asian

Group Psychological Therapy in Obstetric Fistula Care: A ...

African Journals Online (AJOL)

AJRH Managing Editor

Keywords: Obstetric fistula, mental ill health, Group Psychotherapy, South Sudan. Résumé. L'objectif de cette étude est de déterminer l'impact du groupe thérapie psychologique (GPT) sur la ... This conflict led to destruction of many social.

Barriers to obstetric care among maternal near-misses

African Journals Online (AJOL)

(pre-existing medical disease or recurrent miscarriage) or may be caused by pregnancy itself, gestational hypertension or obstetric haemorrhage. ... A serious complication may progress rapidly to a life-threatening situation. Access and ..... complicated pregnancy, mothers should also be counselled about future pregnancy ...

Editorial: Postpartum Depression | Atwoli | Journal of Obstetrics and ...

African Journals Online (AJOL)

Journal of Obstetrics and Gynaecology of Eastern and Central Africa. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 23, No 1 (2011) >. Log in or Register to get access to full text downloads.

Seasonal variation in the Dutch bovine raw milk composition

NARCIS (Netherlands)

Heck, J.M.L.; Valenberg, van H.J.F.; Dijkstra, J.; Hooijdonk, van A.C.M.

2009-01-01

In this study, we determined the detailed composition of and seasonal variation in Dutch dairy milk. Raw milk samples representative of the complete Dutch milk supply were collected weekly from February 2005 until February 2006. Large seasonal variation exists in the concentrations of the main

Evaluation of the Dutch subsurface geoportal: What lies beneath?

NARCIS (Netherlands)

Lance, K.T.; Georgiadou, Y.; Bregt, A.K.

2011-01-01

This paper focuses on a geoportal from a “what lies beneath” perspective. It analyses processes of budgeting, planning, monitoring, performance measurement, and reporting of the national initiative titled Digital Information of the Dutch Subsurface (known by its Dutch acronym, DINO). The study is

The end of the Dutch car tax?

International Nuclear Information System (INIS)

Besseling, P.J.; Lebouille, R.A.J.

2009-01-01

In the framework of the project 'Paying differently for mobility' an option that is considered is to switch the Dutch Tax on Motor cars and Vehicles (BPM) to a higher tariff for the future road pricing system. Due to some special characteristics of the BPM, this will be a highly complex financial operation. In this article, we explore three variants for their effect on the vehicle market and on the budget. We also explain the advantages and disadvantages for several groups of car owners. [nl

Psychometric Properties of the Dutch Rosenberg Self-Esteem Scale

Directory of Open Access Journals (Sweden)

Erik Franck

2008-01-01

Full Text Available Interest in self-esteem has been fuelled by the suggestion that level of self-esteem is associated with psychological well-being. In the present study, we translated the Rosenberg Self-Esteem Scale (RSES into the Dutch language and evaluated its psychometric properties in a sample of 442 adults. The results of both exploratory and confirmatory factor analyses confirmed that a single-factor solution provides the best fit. In addition, the Dutch RSES showed high internal consistency as well as high congruent validity. Overall, these findings support the usefulness of the Dutch RSES as a measure for global self-esteem.

Factors influencing the career interest of medical graduates in obstetrics and gynaecology in Hong Kong: a cross-sectional questionnaire survey.

Science.gov (United States)

Lam, Christy Y Y; Cheung, Charleen S Y; Hui, Annie S Y

2016-04-01

The trend of declining interest of medical graduates in pursuing obstetrics and gynaecology as a career has been observed in many overseas studies. This study aimed to evaluate the career interest of the most recent medical graduates in Hong Kong, especially their level of interest in obstetrics and gynaecology, and to identify key influential factors for career choice and career interest in obstetrics and gynaecology. All medical graduates from the Chinese University of Hong Kong and the University of Hong Kong who attended the pre-internship lectures in June 2015 were invited to participate in this cross-sectional questionnaire survey. The main outcome measures were the level of career interest in obstetrics and gynaecology, the first three choices of specialty as a career, key influential factors for career choice, and key influential factors for career interest in obstetrics and gynaecology. Overall, 73.7% of 323 new medical graduates participated in the study and 233 questionnaires were analysed. The median score (out of 10) for the level of career interest in obstetrics and gynaecology was 3. There were 37 (16.2%) participants in whom obstetrics and gynaecology was among their first three choices, of whom 29 (78.4%) were female. Obstetrics and gynaecology ranked as the eighth most popular career choice. By factor analysis, the strongest key influential factor for career interest in obstetrics and gynaecology was clerkship experience (variance explained 28.9%) and the strongest key influential factor for career choice was working style (variance explained 26.4%). The study confirmed a low level of career interest in obstetrics and gynaecology among medical graduates and a decreasing popularity of the specialty as a career choice. The three key influential factors for career interest in obstetrics and gynaecology and career choice were working style, clerkship experience, and career prospects.

Dutch medical oath

NARCIS (Netherlands)

Westerveld, H. E.; Briet, J. W.; Houwaart, E. S.; Legemaate, J.; Meerman, Th J. A. M.; Breetvelt, E. J.; van der Wall, E.

2005-01-01

In the first part of this article, the booklet Dutch Medical Oath is reviewed. The content of the new oath is discussed as are the reasons for revision of the previous version of the oath. This is followed by a short history of the oath. In the second part of the article the oath is compared with

Validity of the Parental Burnout Inventory Among Dutch Employees.

Science.gov (United States)

Van Bakel, Hedwig J A; Van Engen, Marloes L; Peters, Pascale

2018-01-01

The purpose of this study was to validate the Parental Burnout Inventory (PBI) in a Dutch sample of working parents. The Dutch version of the PBI and questionnaires about work were administered to 627 working parents, with at least one child living at home. We investigated whether the tri-dimensional structure of the PBI held in a sample of male and female employed parents. Furthermore, we examined the relationships between PBI and the constructs work-related burnout, depressive mood, parenting stress and work-family conflict, which we assessed with widely used and validated instruments, i.e., emotional exhaustion [a subscale of the Dutch version of Maslach's Burnout Inventory], a Dutch Parental Stress Questionnaire and Work-Family Conflict. The results support the validity of a tri-dimensional parental burnout syndrome, including exhaustion, distancing and inefficacy. Low to moderate correlations between parents' burnout symptoms and professional exhaustion, parenting stress, depressive complaints and work-family conflict experiences were found, suggesting that the concept of PBI differs significantly from the concepts of job burnout, depression and stress, respectively. The current study confirms that some parents are extremely exhausted by their parental role. However, the number of Dutch employees reporting extreme parental burnout is rather low.

Validity of the Parental Burnout Inventory Among Dutch Employees

Directory of Open Access Journals (Sweden)

Hedwig J. A. Van Bakel

2018-05-01

Full Text Available The purpose of this study was to validate the Parental Burnout Inventory (PBI in a Dutch sample of working parents. The Dutch version of the PBI and questionnaires about work were administered to 627 working parents, with at least one child living at home. We investigated whether the tri-dimensional structure of the PBI held in a sample of male and female employed parents. Furthermore, we examined the relationships between PBI and the constructs work-related burnout, depressive mood, parenting stress and work-family conflict, which we assessed with widely used and validated instruments, i.e., emotional exhaustion [a subscale of the Dutch version of Maslach’s Burnout Inventory], a Dutch Parental Stress Questionnaire and Work-Family Conflict. The results support the validity of a tri-dimensional parental burnout syndrome, including exhaustion, distancing and inefficacy. Low to moderate correlations between parents’ burnout symptoms and professional exhaustion, parenting stress, depressive complaints and work-family conflict experiences were found, suggesting that the concept of PBI differs significantly from the concepts of job burnout, depression and stress, respectively. The current study confirms that some parents are extremely exhausted by their parental role. However, the number of Dutch employees reporting extreme parental burnout is rather low.

The association between prenatal sleep quality and obstetric outcome.

Science.gov (United States)

Hung, Hsuan-Man; Ko, Shu-Hua; Chen, Chung-Hey

2014-09-01

Pregnancy-associated sleep disorder is a new category on the latest version of the International Classification of Sleep Disorders. It is a significant problem for pregnant women. The present follow-up study assesses the association between sleep quality during the second and third trimesters of pregnancy and obstetric-neonatal outcomes. A prospective follow-up study design was used. Follow-up examination of the obstetric birth records in the immediate postpartum period were carried out on 128 second-trimester and 120 third-trimester women and their newborns in two hospitals in Taiwan. Poor sleep quality was identified using the Pittsburgh Sleep Quality Index. Data were collected from October 2007 to June 2008. The prevalence of poor sleepers (Pittsburgh Sleep Quality Index score > 5) was 58% for second-trimester participants and 66% for third-trimester participants; participants who were unemployed reported a significantly higher prevalence of poor sleep quality than those who were employed. Subsequent review of the participant's obstetric birth records revealed that third-trimester poor sleepers were more likely to have had a vacuum-assisted delivery. This study identified poor sleep quality during the third trimester as a novel risk factor for vacuum-assisted delivery. We suggest that prenatal healthcare providers focus greater attention to the sleep disturbance condition of pregnant women and provide proactive sleep counseling to facilitate pregnant women's adjustment to the new psychosocial and physiological demands of motherhood.

Ideology, politics, and personality: shaping forces in Dutch psychology of religion, 1907-1957.

Science.gov (United States)

Belzen, Jacob A

2009-08-01

Although the academic establishment of the psychology of religion in the Netherlands has been stronger than in any other Western country, the start of these developments has been remarkably late (in 1957), especially when taking into account that Dutch academic life: (1) before World War II modeled itself after Germany (where psychology of religion flourished); and (2) was to a considerable extent included in the system of pillarization, which characterized Dutch society at large. The general factors that can be distinguished as having played an important role in the shaping of the situation for psychology of religion in the Netherlands had different impacts in the several universities under consideration.

Dutch gas amendment throws open market to generators

International Nuclear Information System (INIS)

Anon.

1997-01-01

An analysis of the text of an amendment to European Union legislation on gas power production rules from the Dutch government is set out. Its pro-liberalisation stance has profound implications for the French, Belgian and Austrian gas power producers. Reactions to the Dutch proposals are noted and data on gas markets in various Member States is presented in table form. (UK)

ON THE RELATIONSHIP BETWEEN DUTCH AND GERMAN INTEREST-RATES

NARCIS (Netherlands)

DEHAAN, J; PILAT, DJ; ZELHORST, D

1991-01-01

In this paper the relationship between Dutch and German short-term and long-term interest rates is examined. Using cointegration techniques, it is found that the covered interest parity hypothesis holds for short-term interest rates. This evidence supports the recent shift of emphasis of Dutch

Dutch City Network feeds the Innovation of Urban Agriculture

NARCIS (Netherlands)

Jansma, J.E.; Veen, E.J.; Kop, van de P.J.; Eijk, van O.N.M.

2015-01-01

Since 2010, the Dutch City Network on Urban Agriculture (Stedennetwerk in Dutch), has linked up civil servants of fourteen cities in order to see opportunities, share knowledge and solve issues on urban agriculture in their cities. Though it started as an internally focused network for civil

Lion and dragon: four centuries of Dutch-Vietnamese relations

NARCIS (Netherlands)

Kleinen, J.; van der Zwan, B.; Moors, H.; van Zeeland, T.

2008-01-01

Dutch-Vietnamese relations go back as far as the beginning of the seventeenth century. For a long time, relations between the Dutch lion and the Vietnamese dragon have been fragile and even violent. Although the relations were not continuously bad, they remained distant rather than warm. Today