Health-related quality of life in ICU survivors-10 years later.

Many Intensive Care (ICU) survivors experience long lasting impairments in physical and psychological health as well as social functioning. The objective of our study was to evaluate these effects up to 10 years after ICU discharge. We performed a long-term prospective cohort study in patients admitted for longer than 48 h in a medical-surgical ICU.

Early detection of parenting and developmental problems in young children: Non-randomized comparison of visits to the well-baby clinic with or without a validated interview.

Objective: Determine whether the early detection of parenting problems and developmental problems in young children improves with the help of a validated structured interview.

Design: Non-randomized controlled trial held from December 2006 until January 2008.

Setting: Preventive child health care services in the Netherlands.

Early detection of parenting and developmental problems in toddlers: A randomized trial of home visits versus well-baby clinic visits in the Netherlands.

Objective: The early detection of parenting and developmental problems by preventive child health care (CHC) services in the Netherlands takes place almost exclusively at the well-baby clinic. This study assesses whether, compared to a visit to the well-baby clinic, a home visit improves early detection.

Methods: 4481 eligible 18-month-old children and their parents were randomized to either a visit to the well-baby clinic or a home visit in the period from December 2006 to January 2008.

Associations of health behaviors, school performance and psychosocial problems in adolescents in The Netherlands.

School-based health-promoting interventions show promising results in improving various health outcomes of adolescents. Unfortunately, much is still unknown about the relations between health behaviors and school performances, while improving these would give schools a stronger incentive to invest in health promotion. This paper presents the associations of several health behaviors with school performances and studies the mediating effects of psychosocial problems.

ICU survivors show no decline in health-related quality of life after 5 years.

Purpose: Severe critical illness requiring treatment in the intensive care unit (ICU) may have a serious impact on patients and their families. However, optimal follow-up periods are not defined and data on health-related quality of life (HRQOL) before ICU admission as well as those beyond 2 years follow-up are limited. The aim of our study was to assess the impact of ICU stay up to 5 years after ICU discharge.

A Controlled Health Promoting School Study in the Netherlands: Effects After 1 and 2 Years of Intervention.

Purpose: Many unhealthy behavioral habits often originate in adolescence. In the literature, the school-based whole school approach is stated be the most promising way to promote healthy behavior. Herein, interventions are evidence based and integrated into the curriculum, while embedded in complementary healthy school policies and environment.

A comparison of the quality of care in accident and emergency departments in England and the Netherlands as experienced by patients.

Background: Measuring patients' experiences to determine health-care performance and quality of care from their perspective can provide valuable evidence for international improvements in the quality of care. We compare patients' experiences in Accident & Emergency departments (A&E) in England and the Netherlands and discuss the usefulness of this comparison.

Methods: A cross-sectional survey was conducted among patients attending A&Es aged 18 years and older.

Nurse-led clinics for patients with chronic diseases in hospital and transmural care organizations.

Objectives: The objectives of this study were to elucidate the purpose, content, and organization of nurse-led clinics for patients with chronic diseases and to explore whether there are differences in the content and context of the nurse-led clinics and attention for the home situation between a transmural and a hospital setting.

Settings: Transmural setting by which nurses work in both primary and secondary care and hospital setting where nurses are employed by a local hospital. Within the transmural setting, 4 nurse-led clinics were studied: heart failure, rheumatoid arthritis, Parkinson disease, and multiple sclerosis.

Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study.

Background: Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors.

The Consumer Quality Index in an accident and emergency department: internal consistency, validity and discriminative capacity.

Background: Patients' experiences are an indicator of health-care performance in the accident and emergency department (A&E). The Consumer Quality Index for the Accident and Emergency department (CQI A&E), a questionnaire to assess the quality of care as experienced by patients, was investigated. The internal consistency, construct validity and discriminative capacity of the questionnaire were examined.

Multidisciplinary integrated Parent and Child Centres in Amsterdam: a qualitative study.

Background: In several countries centres for the integrated delivery of services to the parent and child have been established. In the Netherlands family health care service centres, called Parent and Child Centres (PCCs) involve multidisciplinary teams. Here doctors, nurses, midwives, maternity help professionals and educationists are integrated into multidisciplinary teams in neighbourhood-based centres.

Changing multiple adolescent health behaviors through school-based interventions: a review of the literature.

Background: In approaches to health promotion in adolescents, unhealthy behaviors are no longer regarded as independent processes, but as interrelated. This article presents a systematic literature review of school-based interventions targeting multiple adolescent behaviors simultaneously.

Methods: A systematic literature search was performed using PubMed, Science Direct, and PsychInfo.

Economic evidence on integrated care for stroke patients; a systematic review.

Introduction: Given the high incidence of stroke worldwide and the large costs associated with the use of health care resources, it is important to define cost-effective and evidence-based services for stroke rehabilitation. The objective of this review was to assess the evidence on the relative cost or cost-effectiveness of all integrated care arrangements for stroke patients compared to usual care. Integrated care was defined as a multidisciplinary tool to improve the quality and efficiency of evidence-based care and is used as a communication tool between professionals to manage and standardize the outcome-orientated care.

A qualitative study of stakeholder views on the effects of provider payment on cooperation, quality of care and cost-containment in integrated stroke care.

Background: Stroke services are a form of integrated care which have been introduced in many countries, including the Netherlands, to improve health outcomes and processes of care by connecting the acute, rehabilitative, and chronic phases of stroke care. Limited research exists on the effects of payment systems on the functioning of integrated care services from the perspectives of those involved in providing, planning and contracting the care. This qualitative study identified stakeholder views on i) challenges in integrated stroke care associated with fee-for-service systems; ii) other possible financing models for stroke care, and iii) challenges in the implementation of an integrated financing mechanism for stroke care.

The effect of acute kidney injury on long-term health-related quality of life: a prospective follow-up study.

Introduction: Acute kidney injury (AKI) is a serious complication in critically ill patients admitted to the Intensive Care Unit (ICU). We hypothesized that ICU survivors with AKI would have a worse health-related quality of life (HRQOL) outcome than ICU survivors without AKI.

Methods: We performed a long-term prospective observational study.

Risk assessment of parents' concerns at 18 months in preventive child health care predicted child abuse and neglect.

Objective: As child maltreatment has a major impact, prevention and early detection of parenting problems are of great importance. We have developed a structured interview which uses parents' concerns for a joint needs assessment by parents and a child health care nurse, followed by a professional judgment on the risk level of future parenting and developmental problems: the Structured Problem Analysis of Raising Kids (SPARK). Previous results have shown that the risk assessment of the SPARK is associated with risk factors for child maltreatment.

Results of a multibehavioral health-promoting school pilot intervention in a Dutch secondary school.

Purpose: Recent studies increasingly show adolescent health-related behaviors to be interrelated, interacting synergistically and sharing several common determinants. Therefore, research increasingly focuses on studying interventions that target a range of health behaviors simultaneously. This report describes the results of a pilot study of a secondary school-based, health-promoting intervention that simultaneously targets a range of adolescent health behaviors via a whole-school approach.

Validity and reliability of a structured interview for early detection and risk assessment of parenting and developmental problems in young children: a cross-sectional study.

Background: Preventive child health care is well suited for the early detection of parenting and developmental problems. However, as far as the younger age group is concerned, there are no validated early detection instruments which cover both the child and its environment. Therefore, we have developed a broad-scope structured interview which assesses parents' concerns and their need for support, using both the parental perspective and the experience of the child health care nurse: the Structured Problem Analysis of Raising Kids (SPARK).

The effect of Helicopter Emergency Medical Services on trauma patient mortality in the Netherlands.

Introduction: Object of this study was to evaluate the effect of the Helicopter Emergency Medical Services (HEMS) on trauma patient mortality and the effect of prehospital time on the association between HEMS and mortality.

Materials And Methods: Trauma patients admitted to a level 1 trauma centre and treated on-scene by the HEMS and Emergency Medical Services (EMS) between 2003 and 2008 were included (n = 186). A control group treated by EMS only (n = 186) was created by matching on ISS, age and severe traumatic brain injury (TBI).

Safety and efficiency of triaging low urgent self-referred patients to a general practitioner at an acute care post: an observational study.

Objective: To assess the safety and efficiency of triaging low urgent self-referred patients at the emergency department (ED) to a general practitioner (GP) based on the Manchester triage system (MTS).

Methods: All self-referred patients in the evening, night and weekends were included in this prospective observational study. Patients were triaged by an ED nurse according to the MTS and allocated to a GP or the ED according to a predefined care scheme.

Changes of health-related quality of life in critically ill octogenarians: a follow-up study.

Background: Intensivists frequently are concerned about whether octogenarians actually will benefit from ICU admission. We studied changes in health-related quality of life (HRQOL) 6 months following ICU discharge in those patients.

Methods: We performed a long-term prospective study in a medical-surgical ICU.

How do COPD patients respond to exacerbations?

Background: Although timely treatment of COPD exacerbations seems clinically important, nearly half of these exacerbations remain unreported and subsequently untreated. Recent studies have investigated incidence and impact of failure to seek medical treatment during exacerbations. Yet, little is known about type and timing of other self-management actions in periods of symptom deterioration.

Effect of an action plan with ongoing support by a case manager on exacerbation-related outcome in patients with COPD: a multicentre randomised controlled trial.

Background: An individualised action plan (AP) is a potentially effective method of helping patients with chronic obstructive pulmonary disease (COPD) to recognise and anticipate early exacerbation symptoms. This multicentre randomised controlled trial evaluates the hypothesis that individualised APs reduce exacerbation recovery time.

Methods: Two hundred and thirty-three patients with COPD (age 65±10 years, forced expiratory volume in 1 s 56±21% predicted) were randomised to receive either an individualised AP (n=111) or care as usual (n=122).

Detecting exacerbations using the Clinical COPD Questionnaire.

Background: Early treatment of COPD exacerbations has shown to be important. Despite a non-negligible negative impact on health related quality of life, a large proportion of these episodes is not reported (no change in treatment). Little is known whether (low burden) strategies are able to capture these unreported exacerbations.