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['You think, like, you're neutral but you're not'Racial and ethnic bias in pain management in Dutch maternity care]. “你以为你是中立的，但你不是”荷兰产科护理中疼痛管理的种族和民族偏见。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-29
Evelien Overtoom, Bahareh Goodarzi, Syllona Kanu, Alana Helberg-Proctor, Ank de Jonge, Kitty Bloemenkamp
{"title":"['You think, like, you're neutral but you're not'Racial and ethnic bias in pain management in Dutch maternity care].","authors":"Evelien Overtoom, Bahareh Goodarzi, Syllona Kanu, Alana Helberg-Proctor, Ank de Jonge, Kitty Bloemenkamp","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the role of racial/ethnic bias in the assessment, management and treatment of pain among maternal and newborn care professionals in the Netherlands.</p><p><strong>Design: </strong>Mixed methods study.</p><p><strong>Method: </strong>Quantitative: retrospective assessment of a prospective cohort of uterine ruptures in the Netherlands (NethOSS, 2016-2018) examining associations between race/ethnicity categories and language barrier, and the response time to pain and maternal/perinatal outcomes. Qualitative: thematic analysis of semi-structured interviews with professionals about racial and ethnic bias in pain assessment, management and treatment.</p><p><strong>Results: </strong>Caesarean section was significantly more frequently performed >180 minutes after the first pain complaint in the non-Western category compared to the Western category (8/15 (53.3%)) vs (1/12 (8.3%))) (OR 12.57, 95% CI 1.28- 123.48). Professionals expressed implicit racial and ethnic bias and stereotypes about pain experience and expression, while mostly perceiving their own practice as unbiased.</p><p><strong>Conclusion: </strong>Racial thinking and notions of ethnic differences in pain assessment, management, and treatment were largely unrecognized.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Noise in meaningful care; plea for a noisy and improvisational care practice]. [噪音在有意义的关怀；请求一个嘈杂和即兴的护理实践]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-27
Sil Kloppenburg, Aldo Houterman, Dick L Willems
{"title":"[Noise in meaningful care; plea for a noisy and improvisational care practice].","authors":"Sil Kloppenburg, Aldo Houterman, Dick L Willems","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Dutch Healthcare Evaluation & Appropriate Use program aims to ensure that only proven effective care is provided. A protocol-based healthcare system is based on an ideal that leaves little room for an improvising healthcare practice with unique patient experiences. This essay articulates the contrast between a technological-rationalist approach to healthcare and the phenomena in healthcare that fall outside this framework. Phenomena that hardly fit within the political ideal of a healthy and productive society, such as suffering, misfortune, and death. Inspired by the philosopher of science Michel Serres, we refer to this as 'noise'. We argue that noise is not only an inconvenient interruption of effective care but, paradoxically, also its prerequisite. A well-functioning system is sensitive to the unprotocolled. In this way, noise undermines the problematic dichotomy between effective and ineffective. Medical practice must always address disruptive elements that do not fit within the discourse of proven effectiveness.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[In search of atrial fibrillation after cryptogenic stroke; suggestions for a broader approach]. 【隐源性脑卒中后房颤的研究】对更广泛方法的建议]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-23
Elles Zock, Anne Mijn Helming, Henk Kerkhoff
{"title":"[In search of atrial fibrillation after cryptogenic stroke; suggestions for a broader approach].","authors":"Elles Zock, Anne Mijn Helming, Henk Kerkhoff","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 25-40% of patients with thromboembolic stroke, current diagnostics fail to identify a cause. It has been shown that prolonged heart rhythm monitoring can detect atrial fibrillation (AF) as the underlying cause in one-third of these patients. Even though an implantable loop recorder detects AF in 37% of cases up to four years after stroke, several studies show no reduction in the number of recurrent strokes with anticoagulation treatment. It seems that a high degree of AF around the stroke, so-called high burden, has a more likely causal link, than AF detected months or years after stroke. Anticoagulation treatment may be more effective in high AF burden stroke patients. A less expensive, non-invasive detection method, applicable immediately after stroke, may be more suitable in practice. Furthermore, recent research shows promising results in the importance of determining electrocardiographic, anatomical and blood biomarkers indicative for an atrial myopathy and better detection AF.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A male with painful shins]. [小腿疼痛的男性]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-21
Elke Stenvers, Hans Feenstra, Annette D van Dalsen, Hilco A F Luning
{"title":"[A male with painful shins].","authors":"Elke Stenvers, Hans Feenstra, Annette D van Dalsen, Hilco A F Luning","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 52 year old male, without medical history, had painful shins for several months. X-ray showed lytic bone reaction and blood results showed a primary hyperparathyroidism. The diagnosis was osteitis fibrosa cystica, a rare, benign bone lesion. Increased parathyroid hormone leads to high osteoclastic bone turnover causes osseous deformities and fractures.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Physical activity and exercise as medicine; insight into the dose-response relationship]. [作为药物的体育活动和锻炼；对剂量-反应关系的洞察]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-21
Sabine Schootemeijer, Esmée A Bakker, Thijs M H Eijsvogels
{"title":"[Physical activity and exercise as medicine; insight into the dose-response relationship].","authors":"Sabine Schootemeijer, Esmée A Bakker, Thijs M H Eijsvogels","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Regular engagement in physical activity reduces the risk for chronic diseases and mortality. Nevertheless, more than half of the Dutch population does not adhere to contemporary physical activity guidelines. We provide insight into the dose-response relationship between physical activity and health benefits, and present novel approaches to enhance the uptake of a physically active lifestyle. Important take-aways are as follows: 1) Due to the curvilinear association, risk reductions with increases in physical activity volumes strongly depend on baseline activity levels. 2) High intensity activities produce similar health benefits in relatively less time compared to activities atmoderate- or low intensity. 3) Novel metrics, such as daily steps or exercise snacks expand the physical activity toolbox and could allow more personalized activity prescriptions.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Home-administered therapy for hyperemesis gravidarum: an example of a successful transition of care from hospital to home]. [家庭给药治疗妊娠剧吐：从医院到家庭护理成功过渡的一个例子]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-16
Laurine L van der Slink, Selma M Mourad
{"title":"[Home-administered therapy for hyperemesis gravidarum: an example of a successful transition of care from hospital to home].","authors":"Laurine L van der Slink, Selma M Mourad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the implementation of home-administered intravenous rehydration for patients with hyperemesis gravidarum (HG) as an alternative to hospital admission.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Method: </strong>Between 11 July 2022 and 1 January 2025, patients with HG requiring intravenous fluids were treated at home. Patient satisfaction was assessed using a structured questionnaire. Primary outcomes were the number of avoided hospital admission days and patient satisfaction.</p><p><strong>Results: </strong>A total of 167 patients received home-administered rehydration, covering 246 treatment episodes and 1,989 treatment days. In 89% of cases rehydration could be administered at home, either fully or partly, resulting in an estimated reduction of 566 inpatient days. In 66% of cases, a single treatment episode was sufficient. Patient satisfaction was high.</p><p><strong>Conclusion: </strong>Home-administered therapy for HG significantly reduced hospital admissions while maintaining high patient satisfaction. The organizational framework we developed may serve as a template for other low-complexity conditions requiring intravenous therapy in the home setting.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Refugee children; the recognition and treatment of psychotrauma]. [难民的孩子;心理创伤的认识与治疗[j]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-14
Mathilde M Overbeek, Merel E Velu, Tanya Schiphorst, Trudy T M Mooren
{"title":"[Refugee children; the recognition and treatment of psychotrauma].","authors":"Mathilde M Overbeek, Merel E Velu, Tanya Schiphorst, Trudy T M Mooren","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Refugee children and their parents face cumulative stressors before, during and after displacement. This renders them vulnerable to develop emotional and behavioral problems, often accompanied by strain on family functioning. Psychotrauma-related symptoms are not always readily identifiable in clinical practice and may present diffusely, including as somatic complaints. Awareness of possible psychotrauma symptoms and thorough screening are therefore essential. When indicated, effective treatment options are available, ranging from low-threshold psychosocial support to specialized mental health care, both individually (EMDR, TF-CBT, KID-NET, Veerkracht) and family-focused (parent-child therapy, systemic therapy, MFT).</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Why control conditions are rarely without effect in clinical intervention research]. [为什么对照条件在临床干预研究中很少没有效果]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-09
Erik J Giltay, Saskia le Cessie
{"title":"[Why control conditions are rarely without effect in clinical intervention research].","authors":"Erik J Giltay, Saskia le Cessie","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Randomized controlled trials (RCTs) often assume an unchanging control condition. When blinding is not feasible, waitlist or standard-care conditions can evoke negative expectations and nocebo effects. Differences between the intervention and control conditions are therefore determined not only therapeutically, but also contextually. Psychopathology and various somatic conditions are increasingly understood as disturbances of a complex dynamic system, in which small changes can trigger large shifts. Effects that may appear to be of little significance, such as the impact that assignment to a control condition has on people's expectations, may have major effects on the outcome.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A woman with dyspnea since childhood: a late diagnosis of Poland syndrome]. 【一名妇女自幼呼吸困难：波兰综合征的晚期诊断】。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-08
Astrid Van Schelvergem, Johan Clukers, Hans Slabbynck
{"title":"[A woman with dyspnea since childhood: a late diagnosis of Poland syndrome].","authors":"Astrid Van Schelvergem, Johan Clukers, Hans Slabbynck","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 62-year-old woman presented with chronic dyspnea since childhood and progressive hypercapnic respiratory failure. Imaging revealed right diaphragmatic elevation, left lung hypoplasia, and absence of left pectoral muscles. Poland syndrome was diagnosed. This case highlights the importance of thorough physical examination and imaging interpretation in identifying rare congenital conditions.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Epistaxis]. 鼻出血。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-07-07
Frederike F S Bult, Lotte Firet, Maureen van den Donk, Robert A Feijen, Jako S Burgers
{"title":"[Epistaxis].","authors":"Frederike F S Bult, Lotte Firet, Maureen van den Donk, Robert A Feijen, Jako S Burgers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Epistaxis, also known as a nosebleed, is common and usually stops spontaneously. However, when a patient visits the general practitioner, various self-care advice can be provided and several treatment options are available. Underlying causes of nosebleeds should be considered. Referral to an otolaryngologist is necessary if nosebleeds are persistent or recurrent. This article discusses the incidence, etiology, treatment, and prevention of nosebleeds.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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