Esophagogastric trauma in Scotland.

Background: This study was designed to investigate the incidence of esophageal (ET) and gastric trauma (GT) in Scotland and to identify factors associated with adverse outcome.

Methods: Population-based study of a prospective multicenter database of 52,887 trauma patients, admitted to 25 hospitals from 1992 to 2002.

Results: Thirty patients [0.

Mortality associated with traumatic injuries in the elderly: a population based study.

Elderly trauma is increasing in incidence and is associated with significant morbidity and mortality. The primary objective of the study was to identify factors associated with survival or mortality in the elderly following trauma. The secondary objective was to compare the epidemiology of trauma in the elderly with younger patients.

Peritoneal dialysis-associated peritonitis rates and outcomes in a national cohort are not improving in the post-millennium (2000-2007).

Background: Peritoneal dialysis (PD)-related peritonitis remains the leading cause of technique failure and a significant cause of morbidity among PD patients. Rates in the literature vary, reflecting differences in study design and in populations. The objective of the present study was to determine peritonitis incidence and outcomes in Scotland and to compare them with national guidelines.

Encapsulating peritoneal sclerosis in the new millennium: a national cohort study.

Background And Objectives: The study aim was to establish the incidence and characterize all encapsulating peritoneal sclerosis (EPS) cases in patients treated by peritoneal dialysis (PD).

Design, Setting, Participants, & Measurements: The patient cohort, which started PD from January 1, 2000, to December 31, 2007, was identified from the Scottish Renal Registry (n = 1238). Possible EPS cases were identified by the ten adult Scottish renal units.

Infrequent attendance in general practice after a major disaster: a problem? A longitudinal study using medical records and self-reported distress and functioning.

Objective: To assess the characteristics and implications for care of infrequent attendance in general practice in the aftermath of disaster.

Methods: A study of the content of electronic medical records (EMRs) in pre- and post-disaster periods linked to an enquiry using self-reported questionnaires administered 3 weeks and 18 months post-disaster. The disaster (explosion of a firework depot in Enschede, The Netherlands) caused 23 deaths, about 1000 people injured and 1200 people who had to relocate.

Health problems presented to family practices in the Netherlands 1 year before and 1 year after a disaster.

Background: Disasters often have negative health consequences. Studies of health problems presented in family practice before and after a disaster are rare. The present study analyzed health problems before and after a disaster and predictors of increased morbidity after the disaster as presented in family practice.

Splenic trauma in Scotland: demographics and outcomes.

Background: Splenic trauma is a common organ injury following blunt abdominal trauma. In order to establish the contemporary epidemiology of blunt splenic trauma in Scotland and to detect risk factors associated with patient outcomes, analysis of a multi-center database of trauma patients was performed.

Methods: The study used data from a prospectively collated multicenter trauma database containing the details of 52,215 trauma patients admitted to participating Scottish hospitals over an 11-year period.

Sexually transmitted infection health-care seeking behaviour in the Netherlands: general practitioner attends to the majority of sexually transmitted infection consultations.

Health-care seeking behaviour for sexually transmitted infection (STI)-related symptoms is not well known in the Netherlands. Within the framework of a large representative study, the second National Survey of General Practice (NIVEL 2001), 9687 persons aged 18 years and older were interviewed about their STI and STI-related health-care seeking behaviour. In total, 1.

The workload of general practitioners does not affect their awareness of patients' psychological problems.

Objective: To investigate if general practitioners (GPs) with a higher workload are less inclined to encourage their patients to disclose psychological problems, and are less aware of their patients' psychological problems.

Methods: Data from 2095 videotaped consultations from a representative selection of 142 Dutch GPs were used. Multilevel regression analyses were performed with the GPs' awareness of the patient's psychological problems and their communication as outcome measures, the GPs' workload as a predictor, and GP and patient characteristics as confounders.

Disaster and subsequent healthcare utilization: a longitudinal study among victims, their family members, and control subjects.

Background: The impact of disasters on primary healthcare utilization is largely unknown. Moreover, it is often overlooked how disaster affects those closest to the primary victims, their family members.

Objective: The objective of this study was to examine the long-term effects of a catastrophic fire on primary healthcare utilization.

The course of post-disaster health problems of victims with pre-disaster psychological problems as presented in general practice.

Background: Survivors of disaster with pre-disaster psychological problems are believed to be at risk for presenting post-disaster psychological and physical morbidity. Up till now this statement is based on cross-sectional studies with self-reported data and without pre-disaster measurement.

Objective: To monitor post-disaster health care utilization and morbidity presented in general practice after a man-made disaster by victims and controls with and without pre-disaster psychological problems.

Prevalence of STI related consultations in general practice: results from the second Dutch National Survey of General Practice.

Background: The role of the GP in the care of sexually transmitted infections (STIs) is unclear.

Aim: We studied the prevalence of STI related consultations in Dutch general practice in order to obtain insight into the contribution of the GP in STI control.

Design Of Study: A descriptive study.

Electronic momentary assessment in chronic pain II: pain and psychological pain responses as predictors of pain disability.

Objectives And Methods: More than 7,100 electronic diaries from 80 patients with chronic pain (mean: 89.3, range 30-115) entered multilevel analyses to establish the statistical prediction of disability by pain intensity and by psychological functioning (fear avoidance, cognitive, and spousal pain responses). We also tested the differences between pre-chronic, recently chronic, and persistently chronic pain in the prediction of disability (impaired physical and mental capacity, pain interference with activities, immobility due to pain).

Electronic momentary assessment in chronic pain I: psychological pain responses as predictors of pain intensity.

Objectives And Methods: Electronic momentary assessment was employed to substantiate the relevance of psychological functioning in chronic pain. More than 7,100 electronic diaries from 80 patients with varying IASP classified types of chronic pain served to investigate to what extent fear-avoidance, cognitive and spousal solicitous and punishing pain responses explained fluctuations in pain intensity and whether patients with pre-chronic, recently chronic and persistently chronic pain differed in this regard.

Results: Psychological pain responses explained 40% of the total variance in pain intensity: almost 24% concerned pain variance that occurred between the CPD patients and 16% pertained to pain variance due to momentary differences within these patients.

Health problems in children and adolescents before and after a man-made disaster.

Objective: The aims of this study were to examine health problems of children (4-12 years old at the time of the disaster) and adolescents (13-18 years old at the time of the disaster) before and after exposure to a fireworks disaster in the Netherlands (May 2000), to compare these health problems with a control group, and to identify risk factors for postdisaster psychological problems.

Method: Because the electronic medical records of family practitioners were used, longitudinal monitoring of health problems from 1 year predisaster until 2 years postdisaster for both victims (N=1,628) and controls (N=2,856) was possible. Health problems were classified according to the International Classification of Primary Care.

The workload of GPs: consultations of patients with psychological and somatic problems compared.

Background: GPs report that patients' psychosocial problems play a part in 20% of all consultations. GPs state that these consultations are more time-consuming and the perceived burden on the GP is higher.

Aim: To investigate whether GPs' workload in consultations is related to psychological or social problems of patients.

Health problems of victims before and after disaster: a longitudinal study in general practice.

Background: We aimed to quantify the health problems and to assess the possible risk factors for developing health problems in persons affected by the explosion of a firework depot at Enschede, The Netherlands, on May 13, 2000. The explosion considerably damaged buildings in the local neighbourhood and caused 22 immediate deaths and injuries in over 1000 people.

Methods: A longitudinal study of (89% of all) victims (n = 9329) and controls (n = 7392) with pre-disaster baseline morbidity for 16 months and post-disaster data for 2.

What is important in evaluating health care quality? An international comparison of user views.

Background: Quality of care from the perspective of users is increasingly used in evaluating health care performance. Going beyond satisfaction studies, quality of care from the users' perspective is conceptualised in two dimensions: the importance users attach to aspects of care and their actual experience with these aspects. It is well established that health care systems differ in performance.

Consumer preferences in social health insurance.

Allowing consumers greater choice of health plans is believed to be the key to high quality and low costs in social health insurance. This study investigates consumer preferences (361 persons, response rate 43%) for hypothetical health plans which differed in 12 characteristics (premium, deductibles, no-claim discount, extension of insurance and financial services, red tape involved, medical help-desk, choice of family physicians and hospitals, dental benefits, physical therapy benefits, benefits for prescription drugs and homeopathy). In 90% the health plan with the most attractive characteristics was preferred, indicating a predominantly rational kind of choice.

Comparison of patient evaluations of health care quality in relation to WHO measures of achievement in 12 European countries.

Objectives: To gain insight into similarities and differences in patient evaluations of quality of primary care across 12 European countries and to correlate patient evaluations with WHO health system performance measures (for example, responsiveness) of these countries.

Methods: Patient evaluations were derived from a series of Quote (QUality of care Through patients' Eyes) instruments designed to measure the quality of primary care. Various research groups provided a total sample of 5133 patients from 12 countries: Belarus, Denmark, Finland, Greece, Ireland, Israel, Italy, the Netherlands, Norway, Portugal, United Kingdom, and Ukraine.

Consumer choice of social health insurance in managed competition.

Objective: To promote managed competition in Dutch health insurance, the insured are now able to change health insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to another, we investigated their reasons for selecting their health insurer and assessed the importance of the supplementary benefit package and the flat-rate premium.

One-time physical therapist consultation in primary health care.

Background And Purpose: One-time physical therapist consultation, prior to possible referral for physical therapy intervention, may enhance the quality of patient care, particularly if the referring physician is uncertain as to whether intervention by a physical therapist will be beneficial. The purpose of this study was to describe the use of consultation by a group of primary care physicians (PCPs) who could refer patients for a one-time consultation.

Subjects And Methods: A 7-month observational study was conducted in the Netherlands with 59 pairs of randomly selected PCPs and physical therapists practicing in primary health care.

Social position of adolescents with chronic digestive disorders.

Objective: To investigate the consequences of having a chronic digestive disorder on the social position of adolescents.

Methods: Five diagnostic groups, including inflammatory bowel disease (IBD), chronic liver diseases, congenital digestive disorders, coeliac disease and food allergy (total n = 758, ages 12-25 years), were each compared with a population-based control group in a multicentre study using a cross-sectional design. Social position was assessed by a mailed questionnaire measuring 24 aspects, categorized as education, leisure activities, friendship, labour participation, financial situation, partnership and sexuality.

Quality of care from the patients' perspective: from theoretical concept to a new measuring instrument.

INTRODUCTION: Patient views on quality of care are of paramount importance with respect to the implementation of quality assurance (QA) and improvement (QI) programmes. However, the relevance of patient satisfaction studies is often questioned because of conceptual and methodological problems. Here, it is our belief that a different strategy is necessary.

Prevalence of chronic benign pain disorder among adults: a review of the literature.

In this review epidemiological studies concerning chronic benign pain among adults are discussed. To this end, studies focusing on chronic pain, reporting prevalences at a population or primary health care level, including subjects aged between 18 and 75 years have been collected and analyzed. Focus of analysis was on research methods, definitions of chronic benign pain used, and reported prevalences.