1.  Title: A study on violence against girls: Report on the International Girl Child Conference, 9-10 March 2009, The Hague, the Netherlands. Author: UNICEF. Innocenti Research Centre; Netherlands. Ministry of Foreign Affairs. Human Rights Division Source: Florence, Italy, UNICEF Innocenti Research Centre, 2009. [97] p. Abstract: This publication summarizes the discussions and outcomes of the International Conference on Violence against the Girl Child. The conference addressed gaps in knowledge, research, and responses to violence against girls in the home, and was a follow-up to the United Nations Secretary-General’s Study on Violence against Children. Language: English Keywords: NETHERLANDS | SUMMARY REPORT | CHILDREN | CHILD ABUSE | SOCIAL PROTECTION | PARENTAL INVOLVEMENT | CARE AND SUPPORT | CHILD MARRIAGE | INTERNET | HUMAN RIGHTS | DOMESTIC VIOLENCE | RECOMMENDATIONS | PREVENTION AND CONTROL | Europe, Western | Europe | Developed Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Political Factors | Child Rearing | Behavior | Health Services | Delivery of Health Care | Health | Marriage Patterns | Marriage | Nuptiality | Information Networks | Communication | Diseases Document Number: 331831 |
2.  Peer Reviewed Title: Religious socialisation and fertility: transition to third birth in the Netherlands. Author: Berghammer C Source: European Journal of Population. 2009 Aug;25(3):297-324. Abstract: Although previous studies have demonstrated that religious people in Europe have larger families, the role played by religious socialization in the context of contemporary fertility behavior has not yet been analysed in detail. This contribution specifically looks at the interrelation between religious socialisation and current religiosity and their impact on the transition to the third child for Dutch women. It is based on data of the first wave of the Netherlands Kinship Panel Study (2002-2004) and uses event history analysis. The transitions to first, second and third birth are modeled jointly with a control for unobserved heterogeneity. The findings provide evidence for an impact of women’s current church attendance as well as religious socilisation measured by their fathers’ religious affiliation, when they were teenagers. A religious family background remains influential even when a woman has stopped attending church. The effects of religious indicators strengthen over cohorts. Moreover, the combined religious make-up of the respondent’s parents also significantly determines the progression of the third child. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | EVENT HISTORY ANALYSIS | RELIGION | SOCIAL BEHAVIOR | CULTURE | FERTILITY | DEMOGRAPHIC TRANSITION | Europe, Western | Europe | Developed Countries | Demographic Analysis | Research Methodology | Sociocultural Factors | Behavior | Population Dynamics | Demographic Factors | Population Document Number: 339899 |
| 3. Title: Adolescents' cortisol responses to awakening and social stress; effects of gender, menstrual phase and oral contraceptives. The TRAILS study. Author: Bouma EM; Riese H; Ormel J; Verhulst FC; Oldehinkel AJ Source: Psychoneuroendocrinology. 2009 Jul;34(6):884-93. Abstract: Studies on the influence of sex hormones on cortisol responses to awakening and stress have mainly been conducted in adults, while reports on adolescents are scarce. We studied the effects of gender, menstrual cycle phase and oral contraceptive (OC) use on cortisol responses in a large sample of adolescents. Data come from TRAILS (TRacking Adolescents' Individual Lives Survey), a prospective population study of Dutch adolescents. This study uses data of 644 adolescents (age 15-17 years, 54.7% boys) who participated in a laboratory session including a performance-related social stress task (public speaking and mental arithmetic). Free cortisol levels were assessed by multiple saliva samples, both after awakening and during the laboratory session. No significant effects of gender and menstrual phase on cortisol responses to awakening were found, while girls using OC displayed a slightly blunted response (F(1, 244)=5.30, p=.02). Cortisol responses to social stress were different for boys and free-cycling girls (F(3, 494)=9.73, p<.001), and OC users and free-cycling girls (F(3, 279)=15.12, p<.001). Unexpectedly, OC users showed no response at all but displayed linearly decreasing levels F(1, 279)=19.03, p<.001) of cortisol during the social stress test. We found no effect of menstrual cycle phase on cortisol responses to social stress (F(3, 157)=0.58, p=.55). The absence of a gender difference in the adolescents' cortisol awakening response found in this study is consistent with previous reports. Our results further suggest that adolescent OC users display slightly blunted cortisol responses after awakening, and that gender differences in cortisol responses to social stress during adolescence are comparable to those described for adult populations, that is, stronger responses in men than in women. Whereas previous work in adults suggested blunted stress responses in OC users compared to men and free-cycling women, adolescent OC users showed no cortisol response. Effects of type of OC could not be studied because of low numbers of OC that were only progestin based. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | ADOLESCENTS | GENDER ISSUES | MENSTRUATION | ORAL CONTRACEPTIVES | STRESS | HORMONES | TRANSCORTIN BOUND CORTISOL ALTERATIONS | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Reproduction | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior | Endocrine System | Physiology | Biology | Hematological Effects | Hemic System Document Number: 342582 |
| 4. Title: Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. Author: de Jonge A; van der Goes BY; Ravelli AC; Amelink-Verburg MP; Mol BW; Nijhuis JG; Bennebroek Gravenhorst J; Buitendijk SE Source: BJOG. 2009 Aug;116(9):1177-84. Abstract: OBJECTIVE: To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care. DESIGN: A nationwide cohort study. SETTING: The entire Netherlands. POPULATION: A total of 529,688 low-risk women who were in primary midwife-led care at the onset of labour. Of these, 321,307 (60.7%) intended to give birth at home, 163,261 (30.8%) planned to give birth in hospital and for 45,120 (8.5%), the intended place of birth was unknown. METHODS: Analysis of national perinatal and neonatal registration data, over a period of 7 years. Logistic regression analysis was used to control for differences in baseline characteristics. MAIN OUTCOME MEASURES: Intrapartum death, intrapartum and neonatal death within 24 hours after birth, intrapartum and neonatal death within 7 days and neonatal admission to an intensive care unit. RESULTS: No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16). CONCLUSIONS: This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MIDWIVES AND MIDWIFERY | PERINATAL MORTALITY | CHILDBIRTH | PREGNANCY OUTCOMES | RISK FACTORS | MATERNAL AGE | Europe, Western | Europe | Developed Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Mortality | Population Dynamics | Pregnancy | Reproduction | Parental Age | Age Factors Document Number: 342276 |
| 5. Title: Estrogens and the risk of complex regional pain syndrome (CRPS). Author: de Mos M; Huygen FJ; Stricker BH; Dieleman JP; Sturkenboom MC Source: Pharmacoepidemiology and Drug Safety. 2009 Jan;18(1):44-52. Abstract: OBJECTIVE: Since complex regional pain syndrome (CRPS) shows a clear female predominance, we investigated the association between the cumulative as well as current exposure to estrogens, and CRPS. METHODS: A population-based case-control study was conducted in the Integrated Primary Care Information (IPCI) project in the Netherlands. Cases were identified from electronic records (1996-2005) and included if they were confirmed during a visit (using International Association for the Study of Pain Criteria), or had been diagnosed by a specialist. Controls were matched to cases on gender, age, calendar time, and injury. Measures of cumulative endogenous estrogen exposure were obtained by questionnaire and included age of menarche and menopause, menstrual life, and cumulative months of pregnancy and breast-feeding. Current estrogen exposure at CRPS onset was retrieved from the electronic medical records and determined by current pregnancy or by the use of oral contraceptive (OC) drugs or hormonal replacement therapy (HRT). RESULTS: Hundred and forty-three female cases (1493 controls) were included in analyses on drug use and pregnancies, while cumulative endogenous estrogen exposure was studied in 53 cases (58 controls) for whom questionnaire data were available. There was no association between CRPS and either cumulative endogenous estrogen exposure, OC, or HRT use. CRPS onset was increased during the first 6 months after pregnancy (OR: 5.6, 95%CI: 1.0-32.4), although based on small numbers. DISCUSSION: We did not find an association between CRPS onset and cumulative endogenous estrogen exposure or current OC or HRT use, but more powered studies are needed to exclude potential minor associations. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CASE STUDIES | RECORDS | PAIN | ESTROGENS | HORMONES | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Information Processing | Information | Signs and Symptoms | Diseases | Endocrine System | Physiology | Biology Document Number: 329753 |
| 6. Title: Effects of the contraceptive patch, the vaginal ring and an oral contraceptive on APC resistance and SHBG: a cross-over study. Author: Fleischer K; van Vliet HA; Rosendaal FR; Rosing J; Tchaikovski S; Helmerhorst FM Source: Thrombosis Research. 2009;123(3):429-35. Abstract: INTRODUCTION: The transdermal patch (20 microg ethinylestradiol+150 microg norelgestromin daily) and the vaginal ring (15 microg ethinylestradiol+120 microg etonogestrel daily) are new contraceptives, designed to deliver a low dose of hormones, suggesting a low exposure. However, few data are available about their risk of venous thrombosis. The objective was to investigate the effect of the patch, the ring, and an oral contraceptive (30 microg ethinylestradiol+150 microg levonorgestrel daily) on activated protein C sensitivity ratio (APC-sr) and on sex hormone-binding globulin (SHBG) levels in plasma. MATERIALS AND METHODS: After a two month wash-out, 13 volunteers were randomly assigned to either the patch followed by the oral contraceptive or vice versa, or the ring followed by the oral contraceptive or vice versa. All treatments lasted two cycles and were separated by a wash-out of two cycles. APC-sr and SHBG levels were determined on day 18-21 of the second cycle of the wash-out and of each treatment period. RESULTS: Compared to the oral contraceptive, both the patch and the ring led to higher APC resistance (mean difference APC-sr 1.1; 95% CI 0.67-1.52 and 0.55; 95% CI 0.11-1.00, respectively) and higher SHBG levels (mean difference 210 nmol/l; 95% CI 134-286 and 148 nmol/l; 95% CI 48-248, respectively). CONCLUSION: The activity of the protein C system in plasma was impaired more by contraceptive patch and vaginal ring than by an oral contraceptive containing the second generation progestagen levonorgestrel. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | ETHINYL ESTRADIOL | VAGINAL RING | ORAL CONTRACEPTIVES | THROMBOSIS | RISK FACTORS | Europe, Western | Europe | Developed Countries | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health Document Number: 330863 |
| 7. Peer Reviewed Title: Predicting preparatory behaviours for condom use in female undergraduate students: a one-year follow-up study. Author: Gebhardt WA; van Empelen P; van Beurden D Source: International Journal of STD and AIDS. 2009 Mar;20(3):161-4. Abstract: The objective of this study is to investigate whether the Theory of Planned Behaviour (i.e. attitude, subjective norm, perceived behavioural control and intention), fluctuations in motivation over time, and variables from the Prototype-Willingness Model (i.e. behavioural expectation and behavioural willingness to have unprotected sex) predict preparatory behaviours for condom use. Sixty-two female undergraduates completed baseline and one-year follow-up questionnaires. Having condoms at home and carrying condoms were predicted by behavioural willingness to have unsafe sex at baseline. Having bought condoms was predicted by the behavioural expectation to use condoms with new partners at baseline. Intention and fluctuations in motivation did not emerge as significant predictors of preparatory actions. Female undergraduates, who are more willing to have unprotected sex under risk-conducive circumstances, are also less likely to prepare adequately for condom use, and thereby increase their chances of encountering such situations. Overall, the findings are in support of the Prototype-Willingness Model. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | YOUTH | WOMEN | CONDOM USE | RISK REDUCTION BEHAVIOR | SEX EDUCATION | MOTIVATION | SEX BEHAVIOR | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Education | Psychological Factors Document Number: 330465 |
| 8. Peer Reviewed Title: Cyproterone acetate- and ethinyloestradiol-containing oral contraceptive as a risk factor for upper extremity deep venous thrombosis-a case report. Author: Kapur R; Stramrood CA; Schutgens RE; van Asbeck BS Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):160-3. Abstract: Deep venous thrombosis of the upper extremity (UEDVT) is a rare variety of deep venous thrombosis. Compared to lower-extremity deep venous thrombosis, less is known about the risk factors for primary UEDVT. We report on a 27-year-old woman with UEDVT extending from the jugular and subclavian veins to the elbow. The thrombosis was possibly provoked by a shoulder trauma, in combination with heterozygosity for the prothrombin G20210A mutation and a protein S-deficiency, which may have been induced by the use of a cyproterone acetate- and ethinyloestradiol (CPA/EE)-containing oral contraceptive. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | THROMBOSIS | ACCIDENTS AND INJURIES | CHROMOSOME ABNORMALITIES | CYPROTERONE ACETATE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | Europe, Western | Europe | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health | Neonatal Diseases and Abnormalities | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Safety | Public Health Document Number: 330935 |
| 9. Title: Estrogens, oral contraceptives and hormonal replacement therapy increase the incidence of cutaneous melanoma: a population-based case-control study. Author: Koomen ER; Joosse A; Herings RM; Casparie MK; Guchelaar HJ; Nijsten T Source: Annals of Oncology. 2009 Feb;20(2):358-64. Abstract: BACKGROUND: Multiple studies showed conflicting results on the association between oral contraceptive (OC) use and the development of cutaneous melanoma (CM). We investigated the association between estrogen use and CM incidence. PATIENTS AND METHODS: Data from PHARMO Pharmacy database and PALGA, the pathology database in The Netherlands, were linked. Women, >or=18 years, with a pathology report of a primary CM from 1 January 1991 to 14 December 2004 and >or=3 years of follow-up before CM diagnosis were eligible cases. Controls were matched for age and geographic region. Multivariate logistic regression was used to calculate adjusted odds ratio (OR) and 95% confidence interval (CI) for the association between CM incidence and estrogen use, OCs and hormonal replacement therapy (HRT), separately. RESULTS: In total, 778 cases and 4072 controls were included. CM risk was significantly associated with estrogen use (>or=0.5 year; adjusted OR = 1.42, 95% CI 1.19-1.69). This effect was cumulative dose dependent (P trend < 0.001). CM risk was also significantly associated with the use of HRT (>or=0.5 year: OR = 2.08; 95% CI 1.37-3.14) and OC (>or=0.5 year: OR = 1.28; 95% CI 1.06-1.54). CONCLUSION: Our study suggests a cumulative dose-dependent increased risk of CM with the use of estrogens. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CLINICAL RESEARCH | MULTIVARIATE ANALYSIS | EPIDEMIOLOGIC METHODS | CASE CONTROL STUDIES | WOMEN | ESTROGENS | CONTRACEPTIVE AGENTS, ESTROGEN | PREVALENCE | DERMATOLOGICAL EFFECTS | CANCER | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | HORMONE REPLACEMENT THERAPY | ADMINISTRATION AND DOSAGE | Europe, Western | Europe | Developed Countries | Research Methodology | Data Analysis | Studies | Demographic Factors | Population | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Measurement | Neoplasms | Diseases | Safety | Public Health | Health | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Drugs Document Number: 331000 |
| 10. Peer Reviewed Title: Adjustment to termination of pregnancy for fetal anomaly: a longitudinal study in women at 4, 8, and 16 months. Author: Korenromp MJ; Page-Christiaens GC; van den Bout J; Mulder EJ; Visser GH Source: American Journal of Obstetrics and Gynecology. 2009 Aug;201(2):160.e1-7. Abstract: OBJECTIVE: We studied psychological outcomes and predictors for adverse outcome in 147 women 4, 8, and 16 months after termination of pregnancy for fetal anomaly. STUDY DESIGN: We conducted a longitudinal study with validated self-completed questionnaires. RESULTS: Four months after termination 46% of women showed pathological levels of posttraumatic stress symptoms, decreasing to 20.5% after 16 months. As to depression, these figures were 28% and 13%, respectively. Late onset of problematic adaptation did not occur frequently. Outcome at 4 months was the most important predictor of persistent impaired psychological outcome. Other predictors were low self-efficacy, high level of doubt during decision making, lack of partner support, being religious, and advanced gestational age. Strong feelings of regret for the decision were mentioned by 2.7% of women. CONCLUSION: Termination of pregnancy for fetal anomaly has significant psychological consequences for 20% of women up to > 1 year. Only few women mention feelings of regret. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | LONGITUDINAL STUDIES | WOMEN | POSTABORTION | POSTABORTION CARE | PSYCHOLOGICAL FACTORS | STRESS | DEPRESSION | CONGENITAL ABNORMALITIES | DECISION MAKING | IMPACT | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Health Services | Delivery of Health Care | Health | Behavior | Mental Disorders | Diseases | Neonatal Diseases and Abnormalities | Communication Document Number: 342609 |
| 11. Title: Influencing risk behavior of sexually transmitted infection clinic visitors: efficacy of a new methodology of motivational preventive counseling. Author: Kuyper L; de Wit J; Heijman T; Fennema H; van Bergen J; Vanwesenbeeck I Source: AIDS Patient Care and STDs. 2009 Jun;23(6):423-31. Abstract: A quasi-experimental study was conducted at a Dutch sexually transmitted infection (STI) clinic to compare the effects of educational counseling and motivational interviewing (MI)-based HIV/STI counseling on determinants of condom use and partner notification at 6-month follow-up. It also examined the feasibility of MI-based counseling in a busy real-life clinic. The counseling approaches were historically compared: respondents in the control condition were recruited between April and July 2005, those in the experimental condition between September and December 2005. The study involved 428 participants. These were all high-risk clients of the STI clinic. Their mean age was 33.7 years, and 39.6% were female. The study showed that MI-based counseling had a more positive effect on self-efficacy, intentions to use condoms with casual partners, and long-term condom use with steady partners. It had no adversarial outcomes on other social cognitions or behaviors compared to educational counseling. Furthermore, MI-based counseling is experienced as a more respectful and structured way of counseling. MI-based counseling was relatively easily implemented into the current clinic procedures. In addition to the implementation of the training, neither specialized staff nor additional or longer client visits were needed. However, some nurses indicated that the new method required more personal investment and effort. Limitations of the current study are the low response rates, the high educational level of most participants, and the small sample size regarding partner notification. Nonetheless, we conclude that MI-based counseling was a more effective approach to preventive counseling compared to educational counseling and feasible in the busy real-life setting. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | NURSES AND NURSING | COUNSELING | SAFER SEX | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONDOM USE | HEALTH EDUCATION | MOTIVATION | PARTNER COMMUNICATION | Europe, Western | Europe | Developed Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Health Personnel | Delivery of Health Care | Health | Clinic Activities | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Risk Reduction Behavior | Education | Psychological Factors | Interpersonal Relations Document Number: 342409 |
| 12. Title: Epidemiology of hormone-related venous thromboembolism. Author: Middeldorp S Source: Thrombosis Research. 2009;123 Suppl 2:S65-9. Abstract: In this short review, I will describe the epidemiology of hormone-related venous thromboembolism (VTE). In particular, the impact of hormones for women who have an increased baseline risk for VTE will be discussed. These include carriers of thrombophilia, women with a positive family history of VTE, and women who have experienced VTE. Furthermore, I will shortly discuss the effects on VTE risk for other hormonal contraceptive and hormone replacement methods. (excerpt) Language: English Keywords: NETHERLANDS | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN | PREVALENCE | THROMBOEMBOLISM | HORMONE REPLACEMENT THERAPY | EPIDEMIOLOGY | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, ESTROGEN | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE SAFETY | Europe, Western | Europe | Developed Countries | Research Methodology | Demographic Factors | Population | Measurement | Embolism | Vascular Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Safety | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Drugs Document Number: 341124 |
| 13. Peer Reviewed Title: The influence of partner relationship quality on fertility. Author: Rijken AJ; Liefbroer AC Source: European Journal of Population. 2009 Feb;25(1):27-44. Abstract: This study examines whether partner relationship quality influences fertility, and if so, in which direction and which aspects of relationship quality are relevant. Competing hypotheses are tested. One hypothesis assumes that higher relationship quality leads to higher rates of childbearing, as a high-quality relationship offers the most favourable environment to raise children. An opposite hypothesis expects that lower relationship quality leads to higher rates of childbearing, as couples might have children in order to improve their relationship. Hazard analyses are performed using three waves of the Panel Study on Social Integration in the Netherlands. Findings indicate that positive as well as negative interaction between partners has a negative effect on first- and higher-order birth rates. This suggests that couples are most likely to have children if they do not have too much negative interaction, but neither interact in a very positive way. Value consensus negatively influences higher-order birth rates. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | COUPLES | FERTILITY | INTERPERSONAL RELATIONS | QUALITY OF LIFE | IMPACT | Europe, Western | Europe | Developed Countries | Family Characteristics | Family and Household | Sociocultural Factors | Population Dynamics | Demographic Factors | Population | Behavior | Social Welfare | Economic Factors | Communication Document Number: 331295 |
| 14. Title: Smart finance solutions: Examples of innovative financial mechanisms for water and sanitation. Author: Singeling M; Claasen F; Casella D; van Daalen T; Fonseca C Source: Amsterdam, Netherlands, KIT Publishers, 2009. 72 p. Abstract: This booklet gives examples of how different financial mechanisms are being used to finance water, sanitation projects and small local businesses that contribute to reaching MDG-7. The first chapter describes different financing mechanisms being applied at household / community (micro-) and at intermediate institutional (meso-) level. It gives examples of how these mechanisms are being used to finance water and sanitation projects or small / medium enterprises. It also provides the reader with some useful links for further reading. The second part describes which business models can be used to obtain different financial mechanisms and gives an overview of how to write a successful business plan or project proposal. It also includes a list of organisations that finance water and sanitation projects / businesses. The booklet is designed as a source of inspiration, rather than a manual. It provides links to further, more in-depth information. (Author's abstract) Language: English Keywords: DEVELOPING COUNTRIES | NETHERLANDS | MANUAL | CASE STUDIES | WATER SUPPLY | WATER QUALITY | SANITATION | HYGIENE | FINANCIAL ACTIVITIES | PLANNING | MANAGEMENT | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Natural Resources | Environment | Water | Public Health | Health | Economic Factors | Organization and Administration Document Number: 331418 |
| 15. Title: The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study. Author: van Hylckama Vlieg A; Helmerhorst FM; Vandenbroucke JP; Doggen CJ; Rosendaal FR Source: BMJ. 2009;339:b2921. Abstract: OBJECTIVE: To assess the thrombotic risk associated with oral contraceptive use with a focus on dose of oestrogen and type of progestogen of oral contraceptives available in the Netherlands. DESIGN: Population based case-control study. SETTING: Six participating anticoagulation clinics in the Netherlands (Amersfoort, Amsterdam, The Hague, Leiden, Rotterdam, and Utrecht). PARTICIPANTS: Premenopausal women <50 years old who were not pregnant, not within four weeks postpartum, and not using a hormone excreting intrauterine device or depot contraceptive. Analysis included 1524 patients and 1760 controls. MAIN OUTCOME MEASURES: First objectively diagnosed episodes of deep venous thrombosis of the leg or pulmonary embolism. Odds ratios calculated by cross-tabulation with a 95% confidence interval according to Woolf's method; adjusted odds ratios estimated by unconditional logistic regression, standard errors derived from the model. RESULTS: Currently available oral contraceptives increased the risk of venous thrombosis fivefold compared with non-use (odds ratio 5.0, 95% CI 4.2 to 5.8). The risk clearly differed by type of progestogen and dose of oestrogen. The use of oral contraceptives containing levonorgestrel was associated with an almost fourfold increased risk of venous thrombosis (odds ratio 3.6, 2.9 to 4.6) relative to non-users, whereas the risk of venous thrombosis compared with non-use was increased 5.6-fold for gestodene (5.6, 3.7 to 8.4), 7.3-fold for desogestrel (7.3, 5.3 to 10.0), 6.8-fold for cyproterone acetate (6.8, 4.7 to 10.0), and 6.3-fold for drospirenone (6.3, 2.9 to 13.7). The risk of venous thrombosis was positively associated with oestrogen dose. We confirmed a high risk of venous thrombosis during the first months of oral contraceptive use irrespective of the type of oral contraceptives. CONCLUSIONS: Currently available oral contraceptives still have a major impact on thrombosis occurrence and many women do not use the safest brands with regard to risk of venous thrombosis. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CONTROL GROUPS | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | ADMINISTRATION AND DOSAGE | THROMBOSIS | RISK FACTORS | PULMONARY EMBOLISM | ESTROGENS | PROGESTATIONAL HORMONES | Europe, Western | Europe | Developed Countries | Research Methodology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Thromboembolism | Embolism | Vascular Diseases | Diseases | Hormones | Endocrine System | Physiology | Biology Document Number: 342467 |
| 16. Peer Reviewed Title: Breastfeeding duration related to practised contraception in the Netherlands. Author: van Wouwe JP; Lanting CI; van Dommelen P; Treffers PE; van Buuren S Source: Acta Paediatrica. 2009 Jan;98(1):86-90. Abstract: AIM: The aim of this study was to gain insight into contraception practised and related to breastfeeding duration. METHODS: Mothers with infants up to 6 months received a questionnaire on infant feeding (breast or formula feeding) and contraception (hormonal or non-hormonal methods). Estimates of the time interval between resuming contraception and cessation of lactation was calculated by Chained Equations Multiple Imputation. RESULTS: Of all women (n = 2710), 30% choose condoms, 22% the combined oral contraceptive pill (OCP) and few other methods. Breastfeeding was started by 80%, and 18% continued up to 6 months. Of the breastfeeding mothers, 5% used hormonal contraception; 7% of women who used hormonal contraception practised breastfeeding. After adjustment for background variables, the use of OCP is strongly associated with formula feeding: after delivery to the third month postpartum, the crude OR being 17.5 (95% CI: 11.3-27.0), the adjusted OR 14.5 (9.3-22.5); between the third and sixth month postpartum, respectively, 13.1 (95% CI: 8.6-19.9) and 11.7 (7.6-17.9). Of all breastfeeding women, 20-27% resumed OCP at 25 weeks postpartum and 80% introduced formula feeding. The time lag between these events is 6 weeks. Hormonal contraception was resumed after formula introduction. CONCLUSION: Mothers avoid hormonal contraception during lactation; they change to formula feeding 6 weeks before they resume the OCP. To effectively promote longer duration of breastfeeding, the BFHI needs to address contraception as practised. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | QUESTIONNAIRES | MOTHERS | INFANT | BREASTFEEDING | BOTTLE FEEDING | TIME FACTORS | CONTRACEPTION CONTINUATION | LACTATION | Europe, Western | Europe | Developed Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Population Dynamics | Contraceptive Usage | Contraception | Family Planning | Maternal Physiology | Physiology | Biology Document Number: 330861 |
| 17. Title: Sources of information and health beliefs related to SARS and avian influenza among Chinese communities in the United Kingdom and The Netherlands, compared to the general population in these countries. Author: Voeten HA; de Zwart O; Veldhuijzen IK; Yuen C; Jiang X; Elam G; Abraham T; Brug J Source: International Journal of Behavioral Medicine. 2009;16(1):49-57. Abstract: BACKGROUND: Ethnic minorities in Europe such as the Chinese may need a special strategy with regard to risk communication about emerging infectious diseases. To engage them in precautionary actions, it is important to know their information sources, knowledge, and health beliefs. PURPOSE: This study's purpose is to study the use of information sources, knowledge, and health beliefs related to SARS and avian flu of Chinese people in the UK and The Netherlands, and to make comparisons with the general population in these countries. METHOD: Results of a self-administered questionnaire among 300 British/Dutch Chinese were compared to data obtained from a computer-assisted phone survey among the general population (n = 800). RESULTS: British/Dutch Chinese got most information about emerging diseases from family and friends, followed by Chinese media and British/Dutch TV. They had less confidence than general groups in their doctor, government agencies, and consumer/patient interest groups. Their knowledge of SARS was high. They had a lower perceived threat than general populations with regard to SARS and avian flu due to a lower perceived severity. They had higher self-efficacy beliefs regarding SARS and avian flu. CONCLUSION: In case of new outbreaks of SARS/avian flu in China, local authorities in the UK and The Netherlands can best reach Chinese people through informal networks and British/Dutch TV, while trying to improve confidence in information from the government. In communications, the severity of the disease rather than the susceptibility appears to need most attention. Language: English Keywords: UNITED KINGDOM | NETHERLANDS | RESEARCH REPORT | COMPARATIVE STUDIES | FOCUS GROUPS | ETHNIC GROUPS | INFLUENZA | VIRAL DISEASES | INFORMATION SOURCES | KNOWLEDGE | BELIEFS | PERCEPTION | MASS MEDIA | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Data Collection | Cultural Background | Population Characteristics | Demographic Factors | Population | Diseases | Information | Sociocultural Factors | Culture | Psychological Factors | Behavior | Communication Document Number: 342004 |
| 18. Peer Reviewed Title: Implanon versus medroxyprogesterone acetate: effects on pain scores in patients with symptomatic endometriosis--a pilot study. Author: Walch K; Unfried G; Huber J; Kurz C; van Trotsenburg M; Pernicka E; Wenzl R Source: Contraception. 2009 Jan;79(1):29-34. Abstract: BACKGROUND: Implanon has been reported to be effective in the treatment of dysmenorrhea. We compared the therapeutic efficacies of depot medroxyprogesterone acetate (DMPA) and Implanon with regard to pain relief in women with endometriosis. STUDY DESIGN: In a clinical research center at a university hospital, 41 patients with dysmenorrhea, nonmenstrual pelvic pain and dyspareunia associated with histologically proven endometriosis were included in an open, prospective, randomized, controlled clinical trial. Twenty-one women were assigned by computer-generated randomization to receive Implanon, and 20 women to receive DMPA. As main outcome measures of this pilot study, we evaluated pain improvement quantified according to visual analog scale score, side effects, vaginal bleeding patterns, withdrawal rate and overall degree of satisfaction. RESULTS: During a follow-up period of 1 year, we ascertained a clear improvement in pain intensity for both treatment options. After 6 months, the average decrease in pain was 68% in the Implanon group and 53% in the DMPA group. The side-effects profile and the overall degree of satisfaction after study termination were comparable for both treatment options. CONCLUSION: Concerning pain relief, the therapeutic efficacy of the contraceptive implant Implanon is not inferior to that of DMPA in symptomatic endometriosis. Language: English Keywords: AUSTRIA | NETHERLANDS | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | ENDOMETRIOSIS | PAIN | PELVIC INFECTIONS | CONTRACEPTIVE AGENTS, PROGESTIN | MEDROXYPROGESTERONE ACETATE | TREATMENT | Developed Countries | Europe, Central | Europe | Europe, Western | Research Methodology | Demographic Factors | Population | Diseases | Signs and Symptoms | Infections | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330538 |
| 19. Peer Reviewed Title: Being and feeling like a woman: respectability, responsibility, desirability and safe sex among women of Afro-Surinamese and Dutch Antillean descent in the Netherlands. Author: Bertens MG; Krumeich A; van den Borne B; Schaalma HP Source: Culture, Health and Sexuality. 2008 Aug;10(6):547-61. Abstract: The objective of this study was to describe and understand gender roles and the relational context of sexual decision-making and safe sex negotiation among Afro-Surinamese and Dutch Antillean women in the Netherlands. Twenty-eight individual in-depth interviews and eight focus group discussions were conducted. In negotiating safe sex with a partner, women reported encountering ambiguity between being respectable and being responsible. Their independence, autonomy, authority and pride inherent to the matrifocal household give them ample opportunity to negotiate safe sex and power to stand firm in executing their decisions. The need to be respectable burdens negotiation practices, because as respectable, virtuous women there would not be the need to use condoms. Respectable women will only participate in serious monogamous relationships, which are inherently safe. Women's desire to feel like a woman, 'to tame the macho-man' and constrain him into a steady relationship, limits negotiation space because of emotional dependency. Respectability seems to enforce not questioning men's sexual infidelity. In developing STI/HIV prevention programmes this ambiguity due to cultural values related to gender roles should be considered. Raising awareness of power differences and conflicting roles and values may support women in safe-sex decision-making. Language: English Keywords: NETHERLANDS | NETHERLANDS ANTILLES | SURINAME | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | WOMEN | IMMIGRANTS | WOMEN'S STATUS | DECISION MAKING | SAFER SEX | PARTNER COMMUNICATION | GENDER RELATIONS | CONDOM USE | EMOTIONS | Developed Countries | Europe, Western | Europe | Caribbean | Americas | South America, Northern | South America | Latin America | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Socioeconomic Factors | Economic Factors | Behavior | Sex Behavior | Interpersonal Relations | Gender Issues | Sociocultural Factors | Risk Reduction Behavior | Psychological Factors Document Number: 329244 |
| 20. Peer Reviewed Title: A resurgent HIV-1 epidemic among men who have sex with men in the era of potent antiretroviral therapy. Author: Bezemer D; de Wolf F; Boerlijst MC; van Sighem A; Hollingsworth TD Source: AIDS. 2008;22(9):1071-1077. Abstract: Reducing viral load, highly active antiretroviral therapy has the potential to limit onwards transmission of HIV-1 and thus help contain epidemic spread. However, increases in risk behaviour and resurgent epidemics have been widely reported posthighly active antiretroviral therapy. The aim of this study was to quantify the impact that highly active antiretroviral therapy had on the epidemic. We focus on the HIV-1 epidemic among men who have sex with men in the Netherlands, which has been well documented over the past 20 years within several long-standing national surveillance programs. We used a mathematical model including highly active antiretroviral therapy use and estimated the changes in risk behaviour and diagnosis rate needed to explain annual data on HIV and AIDS diagnoses. We show that the reproduction number R(t), a measure of the state of the epidemic, declined early on from initial values above two and was maintained below one from 1985 to 2000. Since 1996, when highly active antiretroviral therapy became widely used, the risk behaviour rate has increased 66%, resulting in an increase of R(t) to 1.04 in the latest period 2000-2004 (95% confidence interval 0.98-1.09) near or just above the threshold for a self-sustaining epidemic. Hypothetical scenario analysis shows that the epidemiological benefits of highly active antiretroviral therapy and earlier diagnosis on incidence have been entirely offset by increases in the risk behaviour rate. We provide the first detailed quantitative analysis of the HIV epidemic in a well defined population and find a resurgent epidemic in the era of highly active antiretroviral therapy, most likely predominantly caused by increasing sexual risk behaviour. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | MATHEMATICAL MODEL | QUANTITATIVE RESEARCH | MEN | HOMOSEXUALS | MEN HAVING SEX WITH MEN | ANTIRETROVIRAL THERAPY | DISEASES | SEX BEHAVIOR | RISK BEHAVIOR | EPIDEMICS | Developed Countries | Europe, Western | Europe | Theoretical Models | Research Methodology | Demographic Factors | Population | Behavior | HIV | HIV Infections | Viral Diseases Document Number: 327154 |
| 21. Title: Sex differences in the control of glucose homeostasis. Author: Blaak E Source: Current Opinion In Clinical Nutrition and Metabolic Care. 2008 Jul;11(4):500-4. Abstract: PURPOSE OF REVIEW: A markedly higher prevalence of impaired glucose tolerance has been reported in women than in men, whereas the opposite was seen for impaired fasting glucose. The present review focuses on the underlying mechanisms. RECENT FINDINGS: An increased meal glucose appearance and disturbances in postprandial glucose disposal may contribute to higher glucose concentrations in women. An increased, similar or reduced insulin sensitivity has been reported in women than in men, which makes it unclear to what extent a disturbed insulin-mediated glucose disposal may contribute to increased postprandial glucose concentrations in women. This discrepancy may be explained by differences in the phase of menstrual cycle during the study, the use of oral contraceptives and different degrees of physical fitness. Nevertheless, there are consistent data indicating that women are protected against fatty acid-induced insulin resistance. Furthermore, both disturbances in endogenous glucose output and metabolic clearance of glucose may contribute to the reduced fasting glucose concentrations in women. SUMMARY: There is an urgent need for studies that test whether sex-related disturbances in glucose metabolism may be involved in the pathogenesis of type 2 diabetes and the metabolic syndrome, taking age, menstrual cycle, the use of oral contraceptives and physical activity into account. Language: English Keywords: NETHERLANDS | LITERATURE REVIEW | CLINICAL RESEARCH | ADULTS | WOMEN | PREVALENCE | SEX FACTORS | GLUCOSE METABOLISM EFFECTS | TIME FACTORS | DIABETES | AGE FACTORS | MENSTRUAL CYCLE | ORAL CONTRACEPTIVES, SIDE EFFECTS | FITNESS | Developed Countries | Europe, Western | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Measurement | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Population Dynamics | Diseases | Menstruation | Reproduction | Contraceptive Safety | Safety | Public Health | Health Document Number: 328649 |
| 22. Title: [Sensible family planning: do not have children too late, but not too early either] Verstandige gezinsplanning: niet te laat, maar ook niet te vroeg kinderen Author: Bonneux L; Zaadstra BM; de Beer JA Source: Nederlands Tijdschrift Voor Geneeskunde. 2008 Jul 5;152(27):1507-12. Abstract: Due to family planning, Dutch women are increasingly having their first child between 25 and 35 years of age. Compared to 13 other EU countries, Dutch women are having fewer children both earlier and later on in life. From 1970 onwards in the Netherlands, the mean age at first childbirth has increased by 5 years to 29.4 years. The main cause for the rising age at first childbirth is the decrease in the number of young mothers. In 2006, 7% of all childbearing women had their first child after the age of 36; this is just 4.7% higher than in 1970. The percentage of women remaining childless by delaying childbearing too long increased by 0.9%. Considering the social and medical problems in later life, it would not be wise to encourage women to have their babies at a young age, certainly not before the age of 23. Women planning a family should take into account the decline in natural fertility after the age of 35; the future mothers of the Netherlands seem to be planning and deciding wisely. Language: Dutch Keywords: NETHERLANDS | SUMMARY REPORT | WOMEN | MOTHERS | CHILDBIRTH | REPRODUCTIVE AGE | AGE FACTORS | DELAYED CHILDBEARING | FAMILY PLANNING PROGRAMS | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Population Characteristics | Reproductive Behavior | Fertility | Population Dynamics | Family Planning Document Number: 328959 |
| 23. Title: Use of recombinant activated factor VII in massive postpartum haemorrhage. Author: Bouma LS; Bolte AC; van Geijn HP Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2008 Apr;137(2):172-177. Abstract: Postpartum haemorrhage (PPH) remains an important cause of maternal morbidity and mortality. With regard to morbidity, preservation of the uterus is of paramount importance in fertile women. The objective of the study was to describe the cumulative experience of a cohort of women that were treated with recombinant factor VIIa. In this retrospective, descriptive study we approached all departments of obstetrics and gynaecology in the Netherlands to find out if they had used rFVIIa for this indication. Twenty-seven cases were reported to us. To evaluate each case, we used a standardized case record form. The main cause of PPH was uterine atony (82%). In 21 cases rFVIIa was explicitly given to prevent a hysterectomy. This was successful in 16 cases (76%). Relevant reduction or complete cessation of bleeding after rFVIIa was noted in 24/27 cases (89%). There was a reduction in blood product requirements following rFVIIa administration. The dose of rFVIIa was variable and ranged from 16 to 128 mg/kg. There appears to be a role for the use of rFVIIa in PPH unresponsive to conventional therapy. Recombinant FVIIa can be helpful and avoid an emergency hysterectomy. (author's) Language: English Keywords: NETHERLANDS | DEVELOPING COUNTRIES | RESEARCH REPORT | COHORT ANALYSIS | POSTPARTUM WOMEN | BLEEDING | HYSTERECTOMY | Developed Countries | Europe, Western | Europe | Research Methodology | Puerperium | Reproduction | Signs and Symptoms | Diseases | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325919 |
| 24. Peer Reviewed Title: Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: Systematic review and meta-analysis. Author: Cnossen JS; Vollebregt KC; de Vrieze N; ter Riet G; Mol BW Source: BMJ. British Medical Journal. 2008;336(7653):1117-1120. Abstract: The objective was to determine the accuracy of using systolic and diastolic blood pressure, mean arterial pressure, and increase of blood pressure to predict pre-eclampsia. The design used was a systematic review with meta-analysis of data on test accuracy. The data sources used were Medline, Embase, Cochrane Library, Medion, checking reference lists of included articles and reviews, contact with authors. Without language restrictions, two reviewers independently selected the articles in which the accuracy of blood pressure measurement during pregnancy was evaluated to predict pre-eclampsia. Data were extracted on study characteristics, quality, and results to construct 2×2 tables. Summary receiver operating characteristic curves and likelihood ratios were generated for the various levels and their thresholds. 34 studies, testing 60 599 women (3341 cases of pre-eclampsia), were included. In women at low risk for pre-eclampsia, the areas under the summary receiver operating characteristic curves for blood pressure measurement in the second trimester were 0.68 (95% confidence interval 0.64 to 0.72) for systolic blood pressure, 0.66 (0.59 to 0.72) for diastolic blood pressure, and 0.76 (0.70 to 0.82) for mean arterial pressure. Findings for the first trimester showed a similar pattern. Second trimester mean arterial pressure of 90 mm Hg or more showed a positive likelihood ratio of 3.5 (95% confidence interval 2.0 to 5.0) and a negative likelihood ratio of 0.46 (0.16 to 0.75). In women deemed to be at high risk, a diastolic blood pressure of 75 mm Hg or more at 13 to 20 weeks' gestation best predicted pre-eclampsia: positive likelihood ratio 2.8 (1.8 to 3.6), negative likelihood ratio 0.39 (0.18 to 0.71). Additional subgroup analyses did not show improved predictive accuracy. When blood pressure is measured in the first or second trimester of pregnancy, the mean arterial pressure is a better predictor for pre-eclampsia than systolic blood pressure, diastolic blood pressure, or an increase of blood pressure. (author's) Language: English Keywords: NETHERLANDS | LITERATURE REVIEW | PREGNANT WOMEN | TESTING | PREGNANCY, FIRST TRIMESTER | PREGNANCY, SECOND TRIMESTER | PREECLAMPSIA | BLOOD PRESSURE | MEASUREMENT | RELIABILITY | Developed Countries | Europe, Western | Europe | Population Characteristics | Demographic Factors | Population | Research Methodology | Pregnancy | Reproduction | Pregnancy Complications | Diseases | Hemic System | Physiology | Biology Document Number: 326845 |
| 25. Peer Reviewed Title: Abnormal vaginal bleeding in women of reproductive age: A descriptive study of initial management in general practice. Author: de Vries CJ; Wieringa-de Waard M; Vervoort CL; Ankum WM; Bindels PJ Source: BMC Women's Health. 2008 Apr 15;8:7. Abstract: Abnormal vaginal bleeding (AVB) in women of reproductive age is a common reason for consulting a general practitioner. Nevertheless, how general practitioners (GPs) choose to initially manage AVB is largely unknown, as is the prevalence of underlying pathology of AVB in primary care. To investigate the initial diagnostic procedures and treatment for AVB used in general practice, we performed a descriptive study based on computerised medical records. New consultations for AVB in 2000 and 2001 were selected. Patient characteristics, diagnostic procedures and treatment were analysed. In total, 270 new consultations were included. The majority of patients (75%) consulted the GP for AVB only once. GPs performed diagnostic procedures in 54% of all consultations. Overall, additional diagnostic procedures revealed abnormalities in 11% of women. However, the diagnostic procedures implemented by the GPs varied widely per bleeding type and contraceptive use. Anaemia was found in 36% of 45 women tested. Uterine fibroids were found in 41% of 27 women examined by ultrasound. Medication was prescribed in 34% of all consultations. A gynaecological referral was registered in 4% of all contacts. Initially, GPs tend to follow a policy of expectant management in women of reproductive age with AVB. However, when additional diagnostic procedures were performed, anaemia and uterine fibroids were found in a considerable number of women. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROVIDERS WITH CLIENTS | MENORRHAGIA | METRORRHAGIA | PRIMARY HEALTH CARE | EXAMINATIONS AND DIAGNOSES | TREATMENT | CONTRACEPTIVE AGENTS, FEMALE | REFERRAL AND CONSULTATION | Developed Countries | Europe, Western | Europe | Health Services | Delivery of Health Care | Health | Menstruation Disorders | Diseases | Bleeding | Signs and Symptoms | Medical Procedures | Medicine | Contraceptive Agents | Contraception | Family Planning | Program Activities | Programs | Organization and Administration Document Number: 326126 |
| 26. Peer Reviewed Title: Pregnancy after caesarean section: Fewer or later? Author: Eijsink JJ; van der Leeuw-Harmsen L; van der Linden PJ Source: Human Reproduction. 2008;23(3):543-547. Abstract: It is unclear whether having a Caesarean section results in fewer subsequent pregnancies with longer intervals between pregnancies, an effect which may impact on the reproductive performance of a population. Our aim was to determine the implications of a Caesarean section on the subsequent fecundity and interpregnancy interval. This is a cohort study. The obstetric follow-up of primiparous women who delivered by a Caesarean section of a singleton infant in breech presentation is compared with the follow-up of women who delivered vaginally of a singleton infant after a physiological, uncomplicated pregnancy. A total of 279 women delivered a singleton infant in breech presentation at term. From these women, 165 (59.1%) had a Caesarean section. In this group, 131 (79.4%) women had a subsequent pregnancy. In the reference group of 268 women who delivered vaginally, 208 (77.6%) became pregnant again. The median interval between birth of the first child and the beginning of the next pregnancy was 20 months for the Caesarean section group and 18 months for the reference group. No significant difference in interpregnancy interval between the different groups was found. Women who delivered by Caesarean section at term in their first pregnancy do not have fewer second pregnancies compared with women who delivered vaginally. The interpregnancy interval between first and second pregnancy was not prolonged. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | COHORT ANALYSIS | FOLLOW-UP STUDIES | CLINICAL RESEARCH | WOMEN | CESAREAN SECTION | PREGNANCY INTERVALS | FECUNDITY | PREGNANCY RATE | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Measurements | Fertility | Population Dynamics | Reproduction Document Number: 324960 |
| 27. Peer Reviewed Title: Ovulation inhibition with four variations of a four-phasic estradiol valerate / dienogest combined oral contraceptive: Results of two prospective, randomized, open-label studies. Author: Endrikat J; Parke S; Trummer D; Schmidt W; Duijkers I Source: Contraception. 2008 Sep;78(3):218-225. Abstract: Attempts to improve the tolerability of combined oral contraceptives (COCs) have included the substitution of ethinylestradiol (EE) with 17ß-estradiol (E2). However, this has proved unsatisfactory, specifically in terms of cycle control. To improve upon the poor cycle control seen previously, E2 [in the form of estradiol valerate (E2V); 1 mg of E2V contains 0.76 mg of E2] was combined with dienogest (DNG) in a novel four-phasic regimen. In the current studies, the ovulation-inhibition potency of four variations of this regimen was assessed. Two randomized, open-label, Phase II studies were performed. The first study compared two regimens (Regimens 1A and 2A) with similar dosages of DNG but different lengths of application. Having established in Study 1 that the length of application of Regimen 2A was most suitable, but that the dosages of DNG were too low for effective ovulation inhibition, a second study, which compared two regimens (Regimens 2B and 2C) with similar lengths of application but with increased dosages of DNG, was undertaken. The primary efficacy variable in both studies was the proportion of women with a Hoogland score of 5 or 6 during Cycle 2. The full analysis set comprised 192 and 203 women in Studies 1 and 2, respectively. In Study 1, 10 women (10.9%) in Regimen 1A and 6 women (6.4%) in Regimen 2A had a Hoogland score of 5 or 6. In Study 2, three women (3.1%) in Regimen 2B and one woman (1.0%) in Regimen 2C had a Hoogland score of 5 or 6. There were no safety concerns with any of the regimens. The results of these studies identified a four-phasic COC preparation comprising E2V/DNG that provides efficient ovulation inhibition. It is expected that this regimen will lead to an innovative COC containing E2 instead of EE. (author's) Language: English Keywords: GERMANY | NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | CLINICAL TRIALS | ORAL CONTRACEPTIVES, COMBINED | ESTRADIOL | OVULATION SUPPRESSION | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | Europe, Central | Europe | Developed Countries | Europe, Western | Studies | Research Methodology | Clinical Research | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Estrogens | Hormones | Endocrine System | Physiology | Biology | Contraceptive Mode of Action | Safety | Public Health | Health Document Number: 328124 |
| 28. Peer Reviewed Title: The Netherlands: Childbearing within the context of a "Poldermodel" society. Author: Fokkema T; de Valk H; de Beer J; van Duin C Source: Demographic Research. 2008 Jul 1;19(21):743-794. Abstract: The Netherlands has seen a considerable decline of the period total fertility rate and delayed childbearing, just like all other European countries. The drop in fertility, however, has not been as sharp as in many other regions of Europe. The period total fertility rate in the Netherlands has stabilized since the late 1970s at around 1.6 children per woman, and it has even risen slightly since 1995. In addition, although the Netherlands has one of the oldest first-time mothers, completed fertility is still rather high compared to other European countries, suggesting a strong "catching up" of births by women in their thirties. This chapter provides a comprehensive overview of the main driving forces behind specific fertility trends in the Netherlands. Among other factors, it focuses on changing patterns of home leaving and union formation, declining partnership stability, and the growing acceptability and use of contraception. The chapter also looks at prolonged education, rising labor-force participation of women, economic uncertainties, the growing migrant population, and family policies. Data allowing, and to the extent possible, we examine the effects of these factors on decision-making about parenthood and the timing of childbearing. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | FERTILITY DECLINE | DELAYED CHILDBEARING | TOTAL FERTILITY RATE | MARRIAGE AGE | ADOLESCENT PREGNANCY | ILLEGITIMACY | CONTRACEPTIVE USAGE | MATERNAL AGE | FAMILY SIZE | DIVORCE | LIVING ARRANGEMENTS | LABOR FORCE | WOMEN | SOCIOCULTURAL FACTORS | Developed Countries | Europe, Western | Europe | Fertility Changes | Fertility | Population Dynamics | Demographic Factors | Population | Reproductive Behavior | Fertility Rate | Birth Rate | Fertility Measurements | Marriage Patterns | Marriage | Nuptiality | Social Problems | Contraception | Family Planning | Parental Age | Age Factors | Population Characteristics | Family Characteristics | Family and Household | Residence Characteristics | Population Distribution | Geographic Factors | Human Resources | Economic Factors Document Number: 327728 |
| 29. Peer Reviewed Title: Fertility of Turkish and Moroccan women in the Netherlands: Adjustment to native level within one generation. Author: Garssen J; Nicolaas H Source: Demographic Research. 2008 Jul 18;19(33):1249-1280. Abstract: Cohort data by generation for Turkish and Moroccan women in the Netherlands indicate that the first generation adjust their fertility levels only slowly to that of native Dutch women. These women show even higher rates than presently reported by the countries of origin, and few signs of assimilation in (fertility) behaviour. The second generation, on the other hand, are much closer to native women in this respect than to their mothers. Adjustment to the native Dutch fertility pattern is caused by intergenerational differences, rather than by cultural assimilation of the first generation. (author's) Language: English Keywords: NETHERLANDS | TURKEY | MOROCCO | RESEARCH REPORT | COHORT ANALYSIS | FERTILITY MEASUREMENTS | AGE SPECIFIC FERTILITY RATE | MIGRANTS | ETHNIC GROUPS | Developed Countries | Europe, Western | Europe | Developing Countries | Europe, Southeastern | Africa, North | Africa | Research Methodology | Fertility | Population Dynamics | Demographic Factors | Population | Fertility Rate | Birth Rate | Migration | Cultural Background | Population Characteristics Document Number: 327754 |
| 30. Peer Reviewed Title: Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services. Author: Gomperts RJ; Jelinska K; Davies S; Gemzell-Danielsson K; Kleiverda G Source: BJOG: An International Journal of Obstetrics and Gynaecology. 2008 Aug;115(9):1171-5; discussion 1175-8. Abstract: Women on Web is a service that uses telemedicine to help women access mifepristone and misoprostol in countries with no safe care for termination of pregnancy (TOP). This study reviews the telemedicine service. After an online consultation, women with an unwanted pregnancy of up to 9 weeks are referred to a doctor. If there are no contraindications, a medical TOP is conducted by mail. After maximising the follow up from 54.8 to 77.6%, 12.6% decided not to do the TOP and 6.8% of the women who did the medical TOP at home needed a vacuum aspiration. Telemedicine can provide an alternative to unsafe TOP. Outcomes of care are in the same range as TOP provided in outpatient settings. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | INTERNET | WOMEN | DELIVERY OF HEALTH CARE | HEALTH SERVICES | TELECOMMUNICATIONS | REFERRAL AND CONSULTATION | MISOPROSTOL | RU-486 | HOME CARE | ABORTION | SAFETY | PROGRAM EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Information Networks | Communication | Demographic Factors | Population | Health | Broadcast Media | Mass Media | Program Activities | Programs | Organization and Administration | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Hormone Antagonists | Hormones | Care and Support | Fertility Control, Postconception | Family Planning | Public Health | Program Evaluation Document Number: 328830 Notification |
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