BACKGROUND: Several jurisdictions have pursued reforms that regulate cannabis production and/or sale for adult (non-medical) use. Looking at outcomes of such reforms across multiple jurisdictions may help to identify outcomes that are inherent to non-criminal cannabis supply, as well as provide insight into the outcomes of specific regulation models. METHODS: We identified nine indicators of cannabis policy outcomes and aggregated them into three domains (social outcomes, outcomes in cannabis use, health-related outcomes). We assessed these outcomes across five jurisdictions with different models of regulating cannabis supply (Netherlands, Spain, U.S. states that legalized cannabis, Uruguay, and Canada). We used a three-level systematic literature review, prioritising studies with quasi-experimental design (i.e. comparative and longitudinal). We categorised the studies according to their design and the type of outcome (increase, decrease, or no outcome). RESULTS: Across long-standing as well as recent cannabis supply regimes, and across different models of cannabis supply, our review identified common outcomes: a decrease in cannabis-related arrests, an increase in adult (but not adolescent) cannabis use, and increase in healthcare utilization (not traffic-related). Negative health-related outcomes were most consistently found for the U.S. states that legalised cannabis for adult non-medicinal use (there were limitations to nuancing cannabis supply models across U.S. states). In the remaining jurisdictions (the Netherlands, Spain, Canada, Uruguay), the design or time-frame of the identified studies was limited, and studies on certain outcomes were lacking. CONCLUSIONS: Regulating cannabis supply may be associated with benefits in the social area and with potential harms regarding public health; there may though be trade-offs depending on the choice of a cannabis regulation model. Jurisdictions may attempt to mix and match the present models of cannabis regulation to achieve the best ratio of benefits and harms. More research into the specific parameters influencing cannabis policy outcomes is needed.
- Klíčová slova
- cannabis legalization, cannabis supply regulation, literature review, policy analysis, quasi-experimental design,
- MeSH
- Cannabis * MeSH
- dospělí MeSH
- kontrola léčiv a omamných látek * zákonodárství a právo MeSH
- kouření marihuany * zákonodárství a právo epidemiologie MeSH
- lidé MeSH
- obchod zákonodárství a právo MeSH
- užívání marihuany * zákonodárství a právo MeSH
- zákonodárství lékové * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
- Geografické názvy
- Kanada MeSH
- Nizozemsko MeSH
- Spojené státy americké MeSH
- Uruguay MeSH
INTRODUCTION: Early and lifelong treatment is essential in patients with familial hypercholesterolaemia (FH) due to genetically elevated low-density lipoprotein cholesterol (LDL-C) from the first years of life. In women with FH, lipid-lowering treatment is interrupted during childbearing years due to contraindication of the medication during conception, pregnancy and breastfeeding. However, little is known about the impact of breastfeeding on lipid profile and other risk markers for atherosclerotic cardiovascular disease (ASCVD) in women with FH compared with women without hypercholesterolaemia, and to what extent statins transfer into breast milk.We aim to investigate (1) the association between breastfeeding and serum lipid profile in women with and without FH; (2) the association between breastfeeding and other ASCVD risk markers in women with and without FH and (3) the concentration of statins in breast milk of women with FH. METHODS AND ANALYSIS: FH-FEMINA is a prospective study aiming to include 50 women with FH in Norway, the Netherlands and the Czech Republic. Additionally, 20 women without hypercholesterolaemia will be enrolled as a control group in Norway. Women will be included at the first study visit in gestational week 36, and follow-up visits will be scheduled at 2-4 weeks, and at 3, 6, 9 and 12 months postpartum. Information on lifestyle factors, treatment history and current and previous pregnancies will be collected. At each visit, a non-fasting blood sample, breast milk sample and information on diet, body mass index and blood pressure will be collected. Additional blood samples will be collected from the women with FH at 2, 4, 5, 7, 8, 10 and 11 months postpartum for as long as they are breastfeeding. At (re-)initiation of statin treatment, breast milk samples from women with FH will be collected for drug concentration measurements. ETHICS AND DISSEMINATION: Ethical approval will be obtained prior to study start in all three countries. Participants will be informed about the study and receive ample time to ask questions before the informed consent form is signed. The findings from this study will be disseminated to healthcare professionals, researchers and patients via peer-reviewed scientific article(s), conferences, patient organisations and social media. TRIAL REGISTRATION NUMBER: NCT05367310.
- Klíčová slova
- Cardiovascular Disease, Coronary heart disease, Maternal medicine, Postpartum Women, Primary Prevention,
- MeSH
- biologické markery krev MeSH
- dospělí MeSH
- hyperlipoproteinemie typ II * krev farmakoterapie komplikace MeSH
- kardiovaskulární nemoci * MeSH
- kojení * MeSH
- lidé MeSH
- lipidy * krev MeSH
- mateřské mléko * chemie metabolismus MeSH
- prospektivní studie MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- statiny * terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
- Geografické názvy
- Česká republika MeSH
- Nizozemsko MeSH
- Norsko MeSH
- Názvy látek
- biologické markery MeSH
- lipidy * MeSH
- statiny * MeSH
OBJECTIVES: Despite growing interest, the cost-effectiveness of eHealth interventions for supporting quality of life of people with dementia and their caregivers remains unclear. This study evaluated the cost-effectiveness of the FindMyApps intervention, compared to digital care-as-usual. FindMyApps aims to help people with dementia and their caregivers find and learn to use tablet apps that may support social participation and self-management of people with dementia and sense of competence of caregivers. METHOD: A randomised controlled trial (Netherlands Trial Register NL8157) was conducted, including people with mild cognitive impairment (MCI) or mild dementia and their informal caregivers (FindMyApps n = 76, digital care-as-usual n = 74). Outcomes for people with MCI/dementia were Quality-Adjusted Life-Years (QALYs), calculated from EQ-5D-5L data and the Dutch tariff for utility scores, social participation (Maastricht Social Participation Profile) and quality of life (Adult Social Care Outcomes Toolkit), and for caregivers, QALYs and sense of competence (Short Sense of Competence Questionnaire). Societal costs were calculated using data collected with the RUD-lite instrument and the Dutch costing guideline. Multiple imputation was employed to fill in missing cost and effect data. Bootstrapped multilevel models were used to estimate incremental total societal costs and incremental effects between groups which were then used to calculate Incremental Cost-Effectiveness Ratios (ICERs). Cost-effectiveness acceptability curves were estimated. RESULTS: In the FindMyApps group, caregiver SSCQ scores were significantly higher compared to care-as-usual, n = 150, mean difference = 0.75, 95% CI [0.14, 1.38]. Other outcomes did not significantly differ between groups. Total societal costs for people with dementia were not significantly different, n = 150, mean difference = €-774, 95%CI [-2.643, .,079]. Total societal costs for caregivers were significantly lower in the FindMyApps group compared to care-as-usual, n = 150, mean difference = € -392, 95% CI [-1.254, -26], largely due to lower supportive care costs, mean difference = €-252, 95% CI [-1.009, 42]. For all outcomes, the probability that FindMyApps was cost-effective at a willingness-to-pay threshold of €0 per point of improvement was 0.72 for people with dementia and 0.93 for caregivers. CONCLUSION: FindMyApps is a cost-effective intervention for supporting caregivers' sense of competence. Further implementation of FindMyApps is warranted.
- Klíčová slova
- Dementia, cost-analysis, cost-effectiveness, eHealth, psychosocial interventions, quality of life, randomised controlled trial,
- MeSH
- analýza nákladů a výnosů * MeSH
- demence * terapie ekonomika MeSH
- kognitivní dysfunkce terapie ekonomika MeSH
- kvalita života * MeSH
- kvalitativně upravené roky života MeSH
- lidé středního věku MeSH
- lidé MeSH
- mobilní aplikace ekonomika MeSH
- osoby pečující o pacienty * psychologie ekonomika MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- telemedicína * ekonomika MeSH
- zapojení do společnosti MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Nizozemsko MeSH
Molecular techniques like metabarcoding, while promising for exploring diversity of communities, are often impeded by the lack of reference DNA sequences available for taxonomic annotation. Our study explores the benefits of combining targeted DNA barcoding and morphological taxonomy to improve metabarcoding efficiency, using beach meiofauna as a case study. Beaches are globally important ecosystems and are inhabited by meiofauna, microscopic animals living in the interstitial space between the sand grains, which play a key role in coastal biodiversity and ecosystem dynamics. However, research on meiofauna faces challenges due to limited taxonomic expertise and sparse sampling. We generated 775 new cytochrome c oxidase I DNA barcodes from meiofauna specimens collected along the Netherlands' west coast and combined them with the NCBI GenBank database. We analysed alpha and beta diversity in 561 metabarcoding samples from 24 North Sea beaches, a region extensively studied for meiofauna, using both the enriched reference database and the NCBI database without the additional reference barcodes. Our results show a 2.5-fold increase in sequence annotation and a doubling of species-level Operational Taxonomic Units (OTUs) identification when annotating the metabarcoding data with the enhanced database. Additionally, our analyses revealed a bell-shaped curve of OTU richness across the intertidal zone, aligning more closely with morphological analysis patterns, and more defined community dissimilarity patterns between supralittoral and intertidal sites. Our research highlights the importance of expanding molecular reference databases and combining morphological taxonomy with molecular techniques for biodiversity assessments, ultimately improving our understanding of coastal ecosystems.
- Klíčová slova
- DNA barcoding, Molecular reference database, community ecology, invertebrates,
- MeSH
- bezobratlí genetika klasifikace MeSH
- biodiverzita MeSH
- ekosystém MeSH
- koupací pláže MeSH
- metagenomika metody MeSH
- respirační komplex IV * genetika MeSH
- taxonomické DNA čárové kódování * metody MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Nizozemsko MeSH
- Severní moře MeSH
- Názvy látek
- respirační komplex IV * MeSH
Urban and roadside trees contribute to health and resilience. However, when trees or branches fall, it can cause injuries or deaths. This study examined trends and variations of injuries and deaths due to tree failure in The Netherlands from 1998 to 2021, considering urban-rural location, sex, age and traffic mode. This study is the first to describe long-term trends in injuries and deaths due to tree failure from 1998-2021. The standardised rate of injuries per 1,000,000 population increased from 0.14 (SE 0.10) in 1998 to 0.91 (SE 0.21) in 2021, with an annual percentage increase of 5.3% (p = 0.002). The data shows a strong increase for rural areas, contrary to urban ones. The annual percentage increase in rural areas was 13.2% (p < 0.001) while injuries in urban areas increased with 3.0% (p = 0.026), which revealed large urban-rural disparities. A trend was absent in the frequency of deaths. More attention needs to be given to investigating causes, drivers and stressors associated with tree failure-related injuries. In particular, efforts should be made to reduce the prevalence in rural areas. The increase in injuries over time makes it necessary to create awareness and share knowledge among residents and local governments about tree failure risks.
- Klíčová slova
- Injuries, Mortality, Public health risk, Tree failure, Tree risk management, Urban trees,
- MeSH
- dítě MeSH
- dopravní nehody * mortalita statistika a číselné údaje MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- městské obyvatelstvo MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- rány a poranění * mortalita epidemiologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stromy * MeSH
- venkovské obyvatelstvo MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Nizozemsko epidemiologie MeSH
BACKGROUND AND OBJECTIVES: The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention. RESEARCH DESIGN AND METHODS: A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom. RESULTS: Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery. DISCUSSION AND IMPLICATIONS: There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time.
- Klíčová slova
- Comfort care, Decision-making, Dementia, Family caregiver,
- MeSH
- demence * MeSH
- lidé MeSH
- osoby pečující o pacienty * psychologie MeSH
- péče o umírající MeSH
- pečovatelské domovy * organizace a řízení MeSH
- předběžné plánování péče * MeSH
- rozhodování MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Irsko MeSH
- Itálie MeSH
- Kanada MeSH
- Nizozemsko MeSH
- Spojené království MeSH
Increasing nitrogen depositions adversely affect European landscapes, including habitats within the Natura2000 network. Critical loads for nitrogen deposition have been established to quantify the loss of habitat quality. When the nitrogen deposition rises above a habitat-specific critical load, the quality of the focal habitat is expected to be negatively influenced. Here, we investigate how the quality of habitat types is affected beyond the critical load. We calculated response curves for 60 terrestrial habitat types in the Netherlands to the estimated nitrogen deposition (EMEP-data). The curves for habitat types are based on the occurrence of their characteristic plant species in North-Western Europe (plot data from the European Vegetation Archive). The estimated response curves were corrected for soil type, mean annual temperature and annual precipitation. Evaluation was carried out by expert judgement, and by comparison with gradient deposition field studies. For 39 habitats the response to nitrogen deposition was judged to be reliable by five experts, while out of the 41 habitat types for which field studies were available, 25 showed a good agreement. Some of the curves showed a steep decline in quality and some a more gradual decline with increasing nitrogen deposition. We compared the response curves with both the empirical and modelled critical loads. For 41 curves, we found a decline already starting below the critical load.
- Klíčová slova
- Ammonia, Biodiversity, Critical load, European Vegetation Archive (EVA), Habitat type, Nitrate, Response curve,
- MeSH
- dusík * analýza MeSH
- ekosystém * MeSH
- monitorování životního prostředí * metody MeSH
- půda chemie MeSH
- rostliny metabolismus MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Nizozemsko MeSH
- Názvy látek
- dusík * MeSH
- půda MeSH
It is necessary for nursing staff to have adequate knowledge of malnutrition in older people in order to provide high quality care. This study was conducted to update the Knowledge of Malnutrition-Geriatric (KoM-G) questionnaire to fit different settings and to cross-culturally adapt it to the German, Czech, Dutch and Turkish languages. In Part 1 of the study, the KoM-G questionnaire was updated and adapted for use in different settings. Content validation of the KoM-G 2.0 was carried out in a Delphi study with 16 experts. The final KoM-G 2.0 questionnaire consists of 16 items with a Scale Content Validity Index/Average of 94.5%. In Part 2, the English KoM-G 2.0 was cross-culturally adapted into the German, Czech, Dutch and Turkish languages. In the pilot test, between 96.9% (The Netherlands) and 97.8% (Austria) of the nursing staff rated the items as understandable. The KoM-G 2.0 is an up-to-date questionnaire with a highly satisfactory Content Validity Index. It was cross-culturally adapted into the German, Czech, Dutch, and Turkish languages, and the understandability was high. At the moment, the necessary comprehensive psychometric testing of the KoM-G 2.0 is in process. Afterwards it can be used to compare nurses' knowledge between various countries and settings.
- Klíčová slova
- cross-cultural adaptation, geriatric, knowledge, malnutrition, nursing staff, questionnaire,
- MeSH
- delfská metoda MeSH
- dospělí MeSH
- jazyk (prostředek komunikace) MeSH
- lidé středního věku MeSH
- lidé MeSH
- podvýživa * diagnóza MeSH
- překlady MeSH
- průzkumy a dotazníky MeSH
- psychometrie MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- srovnání kultur * MeSH
- zdraví - znalosti, postoje, praxe MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Německo MeSH
- Nizozemsko MeSH
- Turecko MeSH
OBJECTIVE: Access to family planning services is a human right that plays an essential role in society's health, particularly women's health. The COVID-19 pandemic has affected all aspects of human life including access to family planning services. Accordingly, the main goal of this study was to explore the experiences of women and service providers from the main challenges and obstacles of access to family planning services and abortion services in Bangladesh, Iran, and the Netherlands during the COVID-19 pandemic. METHODS: In this qualitative study, the data were collected through online, telephone, or in-person semi-structured interviews with key informants. Participants selected by purposive sampling method. The participants included women aged 15 to 49 (n = 63) and service providers (n = 54) in the 3 abovementioned countries. These individuals were included from October 2020 until December 2020. Conventional thematic analysis was employed to analyze the collected data. RESULTS: The main extracted themes were challenges (reduction of referral; disruption of access to services; insufficient knowledge; worries among staff; rising prices; and unavailability of some contraceptives), measures (time extension and visit scheduling; telephone, online, and door to door services; and support of the media) and recommendations (health facility improvements; free, online, and closer services; and ongoing trainings and awareness campaigns). CONCLUSION: The COVID-19 pandemic has affected family planning and reproductive health services in different ways and has uncovered existing inequalities in access to these services. However, in Iran, the reported challenges were also rooted in new population policies that have further limited access to family planning and abortion services.
- Klíčová slova
- Abortion, COVID-19, Contraception, Family planning, Reproductive health, Sexual health,
- MeSH
- COVID-19 * epidemiologie MeSH
- indukovaný potrat * MeSH
- lidé MeSH
- pandemie MeSH
- služby plánování rodičovství metody MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Bangladéš epidemiologie MeSH
- Írán epidemiologie MeSH
- Nizozemsko MeSH
Luis Alcocer (Mexico), Christina Antza (Greece), Mustafa Arici (Turkey), Eduardo Barbosa (Brazil), Adel Berbari (Lebanon), Luís Bronze (Portugal), John Chalmers (Australia), Tine De Backer (Belgium), Alejandro de la Sierra (Spain), Kyriakos Dimitriadis (Greece), Dorota Drozdz (Poland), Béatrice Duly-Bouhanick (France), Brent M. Egan (USA), Serap Erdine (Turkey), Claudio Ferri (Italy), Slavomira Filipova (Slovak Republic), Anthony Heagerty (UK), Michael Hecht Olsen (Denmark), Dagmara Hering (Poland), Sang Hyun Ihm (South Korea), Uday Jadhav (India), Manolis Kallistratos (Greece), Kazuomi Kario (Japan), Vasilios Kotsis (Greece), Adi Leiba (Israel), Patricio López-Jaramillo (Colombia), Hans-Peter Marti (Norway), Terry McCormack (UK), Paolo Mulatero (Italy), Dike B. Ojji (Nigeria), Sungha Park (South Korea), Priit Pauklin (Estonia), Sabine Perl (Austria), Arman Postadzhian (Bulgaria), Aleksander Prejbisz (Poland), Venkata Ram (India), Ramiro Sanchez (Argentina), Markus Schlaich (Australia), Alta Schutte (Australia), Cristina Sierra (Spain), Sekib Sokolovic (Bosnia and Herzegovina), Jonas Spaak (Sweden), Dimitrios Terentes-Printzios (Greece), Bruno Trimarco (Italy), Thomas Unger (The Netherlands), Bert-Jan van den Born (The Netherlands), Anna Vachulova (Slovak Republic), Agostino Virdis (Italy), Jiguang Wang (China), Ulrich Wenzel (Germany), Paul Whelton (USA), Jiri Widimsky (Czech Republic), Jacek Wolf (Poland), Grégoire Wuerzner (Switzerland), Eugene Yang (USA), Yuqing Zhang (China).
- MeSH
- hypertenze * farmakoterapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Francie MeSH
- Itálie MeSH
- Nizozemsko MeSH
- Španělsko MeSH