The relationship between unmet care needs in young-onset dementia and the course of neuropsychiatric symptoms: a two-year follow-up study.

Background: Little is known about care needs in young-onset dementia (YOD) patients, even though this information is essential for service provision and future care planning. We explored: (1) care needs of people with YOD, (2) the level of agreement within patient-caregiver dyads on care needs, and (3) the longitudinal relationship between unmet needs and neuropsychiatric symptoms.

Methods: A community-based prospective study of 215 YOD patients-caregiver dyads.

Unmet needs and health-related quality of life in young-onset dementia.

Objectives: Young-onset dementia (YOD) causes specific challenges and issues that are likely to affect health-related quality of life (HRQOL). This study explored patient and caregiver HRQOL and its association with unmet needs in YOD.

Methods: A cross-sectional design was used to study 215 community-dwelling YOD patients and their primary caregivers.

Cognitive reframing for carers of people with dementia.

Background: The balance of evidence about whether psychosocial interventions for caregivers of people with dementia could reduce carers' psychological morbidity and delay their relatives' institutionalisation is now widely regarded as moderately positive (Brodaty 2003; Spijker 2008). Multi-component, tailor-made psychosocial interventions are considered to be particularly promising (Brodaty 2003; Spijker 2008). These interventions involve multiple mechanisms of action.

Quality circles to improve prescribing of primary care physicians. Three comparative studies.

Purpose: To determine the effectiveness of quality circles on prescribing patterns of primary care physicians in Germany and to explore the influence of specific factors on changes.

Methods: Three large non-randomised comparative studies were performed in primary care in Germany, with baseline measurements in 2001 and follow-up measurements in 2003. 1090 physicians were in intervention groups and 2090 physicians in control groups.

Primary care strength linked to prevention programs for cardiovascular disease.

Objective: Primary care plays a central role in the prevention and management of cardiovascular disease. We expected that countries with strong primary care systems would have programs to improve management of disease, but wondered how they dealt with lifestyle interventions delivered in primary care.

Study Design: Observational comparative study.

Influence of watchful waiting on satisfaction and anxiety among patients seeking care for unexplained complaints.

Purpose: We undertook a study to determine whether test-ordering strategy and other consultation-related factors influence satisfaction with and anxiety after a consultation among patients seeking care for unexplained complaints.

Methods: A cluster-randomized clinical trial was conducted in family medicine practices in the Netherlands. Participants were 498 patients with unexplained complaints seen by 63 primary care physicians.

Nurse-patient communication in cancer care: does responding to patient's cues predict patient satisfaction with communication.

Objective: The aim is to investigate the relationship between nurses' cue-responding behaviour and patient satisfaction.

Methods: One hundred patient-nurse conversations about present concerns were videotaped and patients' expression of emotional cues and nurses' cue responses were coded using the Medical Interview Aural Rating Scale. Nurses (N=34) and patients (N=100) were recruited from seven oncology inpatient clinics from a University Medical Centre.

Patient evaluations of accessibility and co-ordination in general practice in Europe.

Objective: To determine whether patient evaluations of the accessibility to general practice and co-ordination with other care providers were associated with characteristics of general practice organizations.

Background: In 1998 patients across Europe perceived that small general practices have better accessibility than large practices. Since then a number of changes in primary care have had impact on accessibility and co-ordination of care.

Patient-oriented intervention in addition to centrally organised checkups improves diabetic patient outcome in primary care.

Background: Logistic support to general practitioners improves the care processes for patients with diabetes but is not sufficient to meet all criteria.

Aim: To introduce patient-oriented interventions by a practice nurse in general practices which already use logistic support to improve the care processes for patients with diabetes.

Design Of Study: A controlled before-after study with delayed intervention in the control group.

Systematic review of implementation strategies for risk tables in the prevention of cardiovascular diseases.

Background: Cardiovascular disease prevention is guided by so-called risk tables for calculating individual's risk numbers. However, they are not widely used in routine practice and it is important to understand the conditions for their use.

Objectives: Systematic review of the literature on professionals' performance regarding cardiovascular risk tables, in order to develop effective implementation strategies.

Pain management: a review of organisation models with integrated processes for the management of pain in adult cancer patients.

Aims And Objectives: This paper reports a review of the literature conducted to identify organisation models in cancer pain management that contain integrated care processes and describe their effectiveness.

Background: Pain is experienced by 30-50% of cancer patients receiving treatment and by 70-90% of those with advanced disease. Efforts to improve pain management have been made through the development and dissemination of clinical guidelines.

The Team Climate Inventory: application in hospital teams and methodological considerations.

Objective: To test the validity, reliability and discriminating capacity of an instrument to assess team climate, the Team Climate Inventory (TCI), in a sample of Dutch hospital teams. The TCI is based on a four-factor theory of team climate for innovation.

Design: Validation study.

An overview of patients' preference for, and satisfaction with, care provided by general practitioners and nurse practitioners.

Aim And Objectives: To assess patients' views on the care provided by nurse practitioners compared with that provided by general practitioners and to determine factors influencing these views.

Background: Many countries have sought to shift aspects of primary care provision from doctors to nurses. It is unclear how patients view these skill mix changes.

General practitioners' workload associated to practice size rather than chronic care organisation.

Objective: This study aimed to explore the associations between chronic care organisation and physician workload in primary care.

Design: Secondary analysis of observational data.

Setting And Participants: One hundred and forty general practices from 10 European countries.

Mix of methods is needed to identify adverse events in general practice: a prospective observational study.

Background: The validity and usefulness of incident reporting and other methods for identifying adverse events remains unclear. This study aimed to compare five methods in general practice.

Methods: In a prospective observational study, with five general practitioners, five methods were applied and compared.

Knowledge transfer and improvement of primary and ambulatory care for patients with anxiety.

Objective: To summarize current evidence on the effectiveness of different knowledge transfer and change interventions for improving primary and ambulatory anxiety care to provide guidance to professionals and policy-makers in mental health care.

Method: We searched electronic medical and psychological databases, conducted correspondence with authors, and checked reference lists. Studies examining the effectiveness of knowledge transfer and interventions targeted at improvement of the recognition or management of anxiety in primary and ambulatory health care settings were included.

Rude or aggressive patient behaviour during out-of-hours GP care: challenges in communication with patients.

Objective: GPs in out-of-hours care report that they feel at risk of rude or aggressive patient behaviour. We tried to get information about the incidence, types and patient characteristics of rude or aggressive behaviour.

Methods: Retrospective, observational study involving the analysis of medical records of all patients who contacted a Dutch GP cooperative between June 2001 and June 2002.

Exploring the black box of change in improving test-ordering routines.

Background: The effects of quality improvement strategies are sometimes limited in spite of a systematic development approach. What elements play a role in the change process is not yet fully understood.

Objective: To explore this 'black box' of change, by analysing the barriers and facilitators GPs perceive during the change process.

Research methods from social science can contribute much to the health sciences.

Objective: Research methods from social science, such as social network analysis, random coefficient modeling, and advanced measurement techniques, can contribute much to the health sciences. There is, however, a slow rate of transmission of social science methodology into the health sciences. This paper identifies some of the barriers for adoption and proposes ideas for the future.

Depressed and a co-morbid condition: more psychotropics prescribed!

Background: Depression often occurs simultaneously with a variety of somatic, psychiatric, and social conditions. Knowledge about differences in the pharmacological treatment of depressed patients with and without co-morbidity is lacking.

Objective: To compare GPs' pharmacological treatment of depressed patients with and without co-morbidity.

Possibilities for transborder cooperation in breast cancer care in Europe: a comparative analysis regarding the content, quality and evidence use of breast cancer guidelines.

To encourage transborder cooperation in breast cancer care in Europe, we explored possibilities with the German-Dutch border area as an example. Evidence-based breast cancer guidelines were searched and compared on the: (1) methodological quality (with AGREE (Appraisal of Guidelines for Research and Evaluation)), (2) content of recommendations and (3) evidence use. The methodological quality of the German (n=2) and Dutch guidelines (n=2) was generally sufficient and comparable, although the applicability and the editorial independence were not clearly documented in the Dutch guidelines.

Effectiveness of nonpharmacological interventions in delaying the institutionalization of patients with dementia: a meta-analysis.

Contemporary healthcare policies are designed to shape the conditions that can help delay the institutionalization of patients with dementia. This can be done by developing support programs that minimize healthcare risks for the patients with dementia and their informal caregivers. Many support programs have been developed, and some of them are effective, but there has been no systematic review with a meta-analysis of all types of nonpharmacological support programs with odds of institutionalization or time to institutionalization as an outcome measure.

Patients' responsiveness to a decision support tool for primary prevention of cardiovascular diseases in primary care.

Objective: Assessment of patients' responsiveness to a decision support tool for primary prevention of cardiovascular diseases (CVDs). The booklet focuses on barriers at patient level.

Methods: Process evaluation of an intervention in primary care.

Comparison of two methods for performing treatment reviews by pharmacists and general practitioners for home-dwelling elderly people.

Rationale, Aims And Objectives: There is room for improvement in pharmacotherapy for elderly outpatients. Studies have shown that collaborating health care professionals [e.g.

What determines the management of anxiety disorders and its improvement?

Introduction: Although anxiety disorders are highly prevalent, lack of correct diagnosis and related concerns about treatment are serious clinical problems. Several factors affect, positively or negatively, management of anxiety and its improvement. A literature review and thematic analysis was executed to obtain an overview of the types of determinants of anxiety care and its improvement.