Thromboembolic complications remain a major public health burden, making antithrombotic agents one of the most widely prescribed groups of medication, but the treatment is often challenging as it... Show moreThromboembolic complications remain a major public health burden, making antithrombotic agents one of the most widely prescribed groups of medication, but the treatment is often challenging as it at the same time increases risk of bleeding. With nationwide data from Statistics Netherlands, antithrombotic therapy and relevant clinical outcomes were comprehensively examined in the patient population of atrial fibrillation, overall or among those with comorbid cancer. The results suggest the patient population was increasingly receiving anticoagulants, driven by the newly introduced medication- direct oral anticoagulant and guided by the CHA2DS2-VASc score, and meanwhile the patient population experienced fewer ischemic stroke and major bleeding. In spite of these promising changes, suboptimal medication adherence and potential underuse of anticoagulants remain directions for further improvement. Antithrombotic agent use during pregnancy was also examined in the general Dutch pregnant population, which featured a surge in antiplatelet prescriptions, and risk of preeclampsia/eclampsia decreased and several newborn outcomes improved simultaneously. Together, the studies presented in this thesis provide an overview of antithrombotic therapy in the Netherlands in recent years, providing insights for further improving this treatment and relevant patient outcomes. Show less
In 1727 the Dutch United East India Company (Verenigde Oostindische Compagnie, or VOC) ship Zeewijk wrecked in the Pelsaert Group of the Houtman Abrolhos Islands.This report details the methodology... Show moreIn 1727 the Dutch United East India Company (Verenigde Oostindische Compagnie, or VOC) ship Zeewijk wrecked in the Pelsaert Group of the Houtman Abrolhos Islands.This report details the methodology, outputs and conclusions of a 2022 field survey conducted between 11 and 17 March 2022. The primary aim was to create a 3D record of the Zeewijk (1727) shipwreck site using photogrammetry. The work would allow for a critical assessment of Mr Hugh Edwards’ claim of finding the wreck of Aagtekerke (1726) on the same site as Zeewijk. It would also better visualise the site for research, management, and public interpretation purposes. The fieldwork successfully mapped the widely dispersed Zeewijk shipwreck site on the inner (inside lagoon) and outer reef (in the surf zone) using digital cameras and GPS positioning. It resulted in significant new findings allowing a re-evaluation of the total count of all iron cannon and anchors in the offshore reef, and inshore lagoon areas.This work, when combined with findings of the earlier ‘Roaring Forties Project’ (Paterson et al. 2019), and more recent research undertaken by the Western Australian (WA) Museum, provides convincing evidence that there is only one shipwreck on the Zeewijk site, and negates the hypothesis of two VOC shipwrecks present within the Pelsaert Group. The resulting updated corpus of high-resolution digital imagery, 3D models and site data will greatly facilitate future studies, public interpretation outputs and on-going site monitoring and management of this highly significant Dutch-Australian mutual heritage site. It is gratefully acknowledged that the field work was primarily funded by a grant from the Embassy of the Kingdom of the Netherlands (GCE-2019-03), with additional funding support provided through the WA Museum/Australian Government’s Underwater Cultural Heritage Program and Flinders University’s Maritime Archaeology Program. Transport, logistics and local knowledge to enable safe access to the Zeewijk site were provided by the Liddon family. Show less
This thesis researches the profession of the upholsterer – or ‘kamerbehanger’ in Dutch – and the role they played in the creation of interiors in the Dutch Republic, in the long eighteenth century ... Show moreThis thesis researches the profession of the upholsterer – or ‘kamerbehanger’ in Dutch – and the role they played in the creation of interiors in the Dutch Republic, in the long eighteenth century (1680-1810). Its research centers on the cities of Amsterdam, The Hague and Haarlem. A total of 234 shops or individual upholsterers working there in this period were found. Hopefully, the index of their names included in this thesis will advance future research. The first chapter describes the way the profession developed, as well as how upholsterers learned the trade, worked, kept their shops and advertised. In the following four chapters, the relation between upholsterer and client is explored in-depth through case studies from the period 1680-1810.Upholsterers provided bed and wall hangings, curtains of all sorts, upholstered furniture and other textile wares. They were a relatively small but diverse group working in the luxury industries, with about 10 shops at any one time in Amsterdam and in The Hague, and about 1-5 shops in Haarlem. Some upholsterers did not have a shop but worked their trade from a single room, or worked for others. Most kept a small shop. For some, this was indeed the best profession (‘le meilleur métier’). Upholsterers such as a Pierre Courtonne or Johannes Deel, working for the Stadholders and the elite of their day, were able to amass fortunes of 20,000-50,000 guilders and played a role in designing interiors. Succes was dependent on factors such as seed money, an up-to-date knowledge of current fashions, and maintaining good relations with clients. Most shops went from father to son, and most of the upholsterers working in the Republic were locals. Only a small percentage were foreign-born, and even though France exercised a large influence on the luxury market in the eighteenth century, this is not reflected in the number of French upholsterers settling in the Republic. Only at the end of the century can an increase in their number be seen, and a handful of ‘French upholsterers’ settle in Holland. They seem to have had an advantage over their Dutch colleagues in that they were able to purchase the latest French wares directly through their connections.Regarding the relationship with their clients, it has been found that most upholsterers played the role of advisor and facilitator, when helping their clients buy a new interior or furniture. All-in-all, the case studies show how upholsterers would balance their client’s quest for the newest and most fashionable furniture and interiors with their budget and the available goods. Show less
In response to the shortage of nursing staff and the so-called refugee crisis in 2015, two residential homes invited first-generation immigrants with a refugee background to participate in a... Show moreIn response to the shortage of nursing staff and the so-called refugee crisis in 2015, two residential homes invited first-generation immigrants with a refugee background to participate in a project for nursing education, orientation and internships. Between 2015 and 2018, a group of ten immigrants started working in a Dutch residential home and a group of seventeen immigrants in the German home. This dissertation investigates the social processes when these newcomers start working with the established staff, as well as the extent to which their mutual interactions and values of good care influence the enactment of geriatric care. Using ethnographic observations (305 hours), in-depth interviews (44) and six focus groups (24), the established care workers and immigrants were followed in both homes. The empirical data shows that institutional constraints, such as staff shortage, the imposition of professional norms, gossip used as a ‘weapon of the weak’, mutual suspicions of indifference, and collective images of ‘us’ versus ‘them’ affected the enactment of geriatric care. Their habitus stimulated them to tinker among each other as well as with different, sometimes conflicting, values of good care. However, both groups shared the feeling of ignorance by management, a pain of not mattering. Show less
The impact of COVID-19 on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires... Show moreThe impact of COVID-19 on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires hospital and/or ICU admission, results in prolonged and chronic illness, or leads to premature death. We aimed to quantify the total disease burden of acute COVID-19 in the Netherlands in 2020 using the disability-adjusted life-years (DALY) measure, and to investigate how burden varies between age-groups and occupations. Using standard methods and diverse data sources (mandatory notifications, population-level seroprevalence, hospital and ICU admissions, registered COVID-19 deaths, and the literature), we estimated years of life lost (YLL), years lived with disability, DALY and DALY per 100,000 population due to COVID-19, excluding post-acute sequelae, stratified by 5-year age-group and occupation category. The total disease burden due to acute COVID-19 was 286,100 (95% CI: 281,700-290,500) DALY, and the per-capita burden was 1640 (95% CI: 1620-1670) DALY/100,000, of which 99.4% consisted of YLL. The per-capita burden increased steeply with age, starting from 60 to 64 years, with relatively little burden estimated for persons under 50 years old. SARS-CoV-2 infection and associated premature mortality was responsible for a considerable direct health burden in the Netherlands, despite extensive public health measures. DALY were much higher than for other high-burden infectious diseases, but lower than estimated for coronary heart disease. These findings are valuable for informing public health decision-makers regarding the expected COVID-19 health burden among population subgroups, and the possible gains from targeted preventative interventions. Show less
Heus, E. de; Duijts, S.F.A.; Zwan, J.M. van der; Kapiteijn, E.; Dijkum, E.J.M.N. van; Herpen, C.M.L. van; Merkx, M.A.W. 2022
Introduction: Epidemiological discrepancies exist between rare and common can-cers. The aim of this population-based study was to compare rare versus common adult solid cancers in the Netherlands,... Show moreIntroduction: Epidemiological discrepancies exist between rare and common can-cers. The aim of this population-based study was to compare rare versus common adult solid cancers in the Netherlands, by providing incidence, prevalence and survival rates, evaluating trends in survival and comparing individual entities within domains and families.Methods: All adult patients with malignant solid cancers in the Netherlands between 1995 and 2019 were identified from the Netherlands Cancer Registry. Data on patient, tumour and treatment characteristics were collected, and relative survival and survival trends were ana-lysed.Results: A total of 170,628 patients with rare adult solid cancers and 806,023 patients with common adult solid cancers were included. Rare cancers accounted for 18% of all cancer di-agnoses (mean incidence), and 15% of the total ten-year cancer prevalence during 2010-2019. Overall 5-year survival was worse for rare cancers than for common cancers (52.0% versus 68.7%). Between 1995-1999 and 2015-2019, 5-year survival rates for rare cancers increased to a lesser extent (from 46.2% to 52.6%, i.e. 6.4%) than for common cancers (56.9% Show less
Although the Netherlands remained neutral during the First World War, its population was nonetheless affected by the war. Already in the 1920s and 1930s, Dutch journalists wrote about the... Show moreAlthough the Netherlands remained neutral during the First World War, its population was nonetheless affected by the war. Already in the 1920s and 1930s, Dutch journalists wrote about the possibility of a war in which the Netherlands would also be involved. From the early 1920s to the German invasion in May 1940, journalists, political commentators, politicians, military officials and civilians were occupied by the question what tomorrow’s war might look like. This book captures their efforts and brings to life the cultural memories of the First World War and the expectations for the war to come.By focusing on the dynamics of cultural memories, predictions for the future, and the resultant fear and anxiety, this book provides a better understanding of the ways in which the cultural memories of the Great War and expectations for a future war were part of Dutch society. It draws from a wide array of sources, ranging from newspaper clippings, novels, films and theatre plays to political cartoons and paintings. Most importantly, this study has a unique perspective. Whereas most existing studies look back from the Second World War, this book instead looks forward from the interbellum. Show less
Introduction: The revised Dutch colorectal cancer guideline (2014), led to an overall decrease in preoperative radiotherapy (RT) use. This study evaluates hospital variation in RT use for... Show moreIntroduction: The revised Dutch colorectal cancer guideline (2014), led to an overall decrease in preoperative radiotherapy (RT) use. This study evaluates hospital variation in RT use for resectable rectal cancer and the influence of guideline revision, including the nationwide impact of changing RT application on short term outcomes.Methods: Data of surgically resected rectal cancer patients registered in the Dutch ColoRectal Audit were extracted between 2011 and 2017. Patients were divided into groups based on time of guideline revision (<2014 and >= 2014). Primary outcome was guideline adherence at hospital level regarding RT application, stratified for three stage groups. Secondary outcomes included positive circumferential resection (CRM+) and 30-day complicated postoperative course.Results: The groups consisted of 7364 and 12,057 patients, respectively. In total, 6772 patients did not receive RT (17.6% (<2014) vs. 45.7% (>= 2014), p < 0.001). The largest increase of surgery alone was observed for cT1-2N0 stage rectal cancer (35.1% vs. 91.8%, p < 0.001), with a substantial decrease in hospital variation (IQR 22.2-50.0% vs. IQR 87.6-98.0%). For cT1-3N1MRF-stage rectal cancer, a substantial amount of hospital variation in short course RT remained after guideline revision (IQR 26.8-54.1% vs. IQR 26.2-50.0%). A significant decrease in CRMthorn (5.8% vs. 4.2%, p < 0.001) and complicated course (22.5% vs. 18.5%, p < 0.001) was observed.Conclusions: Radiotherapy for early-stage rectal cancer was uniformly abandoned after guideline revision, while substantial hospital variation remained for intermediate risk resectable rectal cancer in the Netherlands. The substantial nationwide decrease in the use of RT for rectal cancer treatment did not negatively impact CRM involvement. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. Show less
This paper examines the productive role of secrecy in the nexus of transnational mobility, kinship, and intimate relations among Ghanaian-Dutch and Somali-Dutch in the Netherlands. Whereas secrecy... Show moreThis paper examines the productive role of secrecy in the nexus of transnational mobility, kinship, and intimate relations among Ghanaian-Dutch and Somali-Dutch in the Netherlands. Whereas secrecy is typically understood as one person concealing knowledge from another, implying the latter’s passivity, we argue that secrecy depends on mutually constitutive interactions. Secrecy is explored as the result of an interaction between those who obscure knowledge in creative ways and those who maintain a not-knowing. The paper analyzes how people negotiate moral expectations regarding sexuality, respect, and loyalty, while also manoeuvring to fulfil their personal aspirations. Especially in kinship relations, when people are bound to each other by moral and social obligations, the management of secrecy often makes people mutually dependent. Secrecy is revealed as skillfully choreographing relations by the ebb and flow of information where kinship, respect, or love and (not-) knowing reinforce another. Show less
Aim This study aimed to determine predictive factors for the circumferential resection margin (CRM) within two northern European countries with supposed similarity in providing rectal cancer care.... Show moreAim This study aimed to determine predictive factors for the circumferential resection margin (CRM) within two northern European countries with supposed similarity in providing rectal cancer care. Method Data for all patients undergoing rectal resection for clinical tumour node metastasis (TNM) stage I-III rectal cancer were extracted from the Swedish ColoRectal Cancer Registry and the Dutch ColoRectal Audit (2011-2015). Separate analyses were performed for cT1-3 and cT4 stage. Predictive factors for the CRM were determined using univariable and multivariable logistic regression analyses. Results A total of 6444 Swedish and 12 089 Dutch patients were analysed. Over time the number of hospitals treating rectal cancer decreased from 52 to 42 in Sweden, and 82 to 79 in the Netherlands. In the Swedish population, proportions of cT4 stage (17% vs 8%), multivisceral resection (14% vs 7%) and abdominoperineal excision (APR) (37% vs 31%) were higher. The overall proportion of patients with a positive CRM (CRM+) was 7.8% in Sweden and 5.4% in the Netherlands. In both populations with cT1-3 stage disease, common independent risk factors for CRM+ were cT3, APR and multivisceral resection. No common risk factors for CRM+ in cT4 stage disease were found. An independent impact of hospital volume on CRM+ could be demonstrated for the cT1-3 Dutch population. Conclusion Within two northern European countries with implemented clinical auditing, rectal cancer care might potentially be improved by further optimizing the treatment of distal and locally advanced rectal cancer. Show less
Wijhe, M. van; Boer, P.T. de; Jong, H.J. de; Vliet, H. van; Wallinga, J.; Postma, M.J. 2019
This paper reviews the military context of exposure to combat and deployment in Dutch soldiers. It does so by reviewing war victims and military psychiatry after WWII in the Netherlands, and... Show moreThis paper reviews the military context of exposure to combat and deployment in Dutch soldiers. It does so by reviewing war victims and military psychiatry after WWII in the Netherlands, and describes Dutch deployments from the late 1970s to the present. Who is the Dutch soldier' is asked to articulate the mental load on the individual soldier before, during, and after deployment. The narrative review of this paper allows one to review how the armed forces personnel is challenged in relation to their specific assignment and in what respect the psychological dimensions are addressed and met in the face of risk and adversity. Finally, some critical considerations for future veterans care programmes are raised. Show less
Gradl, G.; Teichert, M.; Kieble, M.; Werning, J.; Schulz, M. 2018
