Aim: The Dutch Sentinel General Practice Network (SGPN) was founded in 1970 for disease surveillance in primary care, based on paper questionnaires. Advances in information technology offered new prospects of data collection from electronic health records (EHRs). This study investigates the resulting challenges for the SGPN and its transition towards electronic data collection. Methods: A qualitative approach included triangulation of SGPN annual reports, network publications, its computerisation project protocol of 2004, public health policy documents, and expert interviews. Results: In the 1990s, the design of the SGPN, coordinated by the research institute NIVEL, no longer corresponded to new Dutch government information demands regarding developments in primary care utilisation and quality. The emergence of the EHR-based Netherlands Information Network of General Practice (LINH) could have rendered the SGPN obsolete. However, NIVEL researchers recognised that routine EHR data on health problems could not fully provide required information obtained by questionnaires and samples for laboratory analysis. They developed a plan (1) taking EHR-based routine data collection as a basis, and (2) simultaneously retaining the more detailed supplementary data collection that was the core of the SGPN. The transition towards electronic data collection from 2005 onwards was followed by the integration of both networks into the NIVEL Primary Care Database in 2014. Conclusion: The Dutch model is an example of a process responding to the challenges and opportunities associated with the emergence of electronic data collection, leading towards the integration of routine and supplementary data collection for both sentinel surveillance and health services research.
With regard to the history of nursing in Germany, the nineteenth century turned out to be a century of success for the denominational motherhouse organizations-both for Catholic orders and for Protestant deaconesses.Owing to the revival of Catholicism, Catholic orders in particular 1 proliferated throughout Germany, and the provision of nursing services was an important part of their social work. However, in the 1870s, the fact that the expulsion of Catholic orders from Prussian territory during the Kulturkampf coincided with a cholera epidemic gave the idea of the secular training of both women and men in nursing-an otherwise negligible item on the list of governmental priorities-a prominent place on the political agenda. Th is article explores the reasons why the Prussian state, despite the political, social, and health crises that it was passing through, ultimately decided to do next to nothing-a decision that determined the future of nursing in Prussia for decades to come.
Aspects of the Prussian Health System with Regard to NursingIn Prussia, nursing was not recognized as part of the health professions, such as medicine and midwifery. If the occupation of medical aide (Heilgehilfe), also known as medical servant (Heildiener), was given legal status in the 1850s, it was only in order to fi t the requirements and the convenience of physicians. Medical aides were allowed to give medical assistance and carry out minor surgery delegated to them by a physician. 2 Th ere were no minimum requirements for entry into nursing practice and no state nursing examination. Medical Nursing History Review 16 (
BackgroundThe number of newly diagnosed gonorrhoea and syphilis cases has increased in Flanders in recent years. Our aim was to investigate, to which extent these diagnoses were registered by general practitioners (GPs), and to examine opportunities and limits of the Intego database in this regard.MethodsData from a retrospective cohort study based on the Flemish Intego general practice database was analyzed for the years 2009–2013. Case definitions were applied. Due to small case numbers obtained, cases were pooled and averaged over the observation period. Frequencies were compared with those calculated from figures of mandatory notification.ResultsA total of 91 gonorrhoea and 23 syphilis cases were registered. The average Intego annual frequency of gonorrhoea cases obtained was 11.9 (95% Poisson confidence interval (CI) 9.6; 14.7) per 100,000 population, and for syphilis 3.0 (CI 1.9; 4.5), respectively, while mandatory notification was calculated at 14.0 (CI: 13.6, 14.4) and 7.0 (CI: 6.7, 7.3), respectively.ConclusionIn spite of limitations such as small numbers and different case definitions, comparison with mandatory notification suggests that the GP was involved in the large majority of gonorrhoea cases, while the majority of new syphilis cases did not come to the knowledge of the GP.
Background General practitioners (GPs) as a group have been identified as playing an important role in gonorrhoea management in Flanders. Belgian guidelines recommended ceftriaxone or alternatively spectinomycin from 2008 onwards and azithromycin combination therapy since 2012. Objectives This study investigates to which extent contemporary gonorrhoea treatment guidelines were followed. Methods A retrospective cohort study (2009–2013) of antibiotic prescriptions for gonorrhoea cases registered in the Flemish Intego general practice database was carried out. The database is based on electronic health record routine registration by over 90 GPs using the software programme Medidoc. Results Ninety-one gonorrhoea cases with ten chlamydia and one genital trichomonas coinfections in 90 patients were registered between 2009 and 2013. The proportion of cases with ceftriaxone and/or spectinomycin prescriptions rose from 13% (two of 15 cases) in 2009 to 56% (nine of 16 cases) in 2013. Combination therapy of ceftriaxone and/or spectinomycin together with azithromycin rose from 0 of 15 cases (0%) in 2009 to 7 of 16 cases (44%) in 2013. Conclusion Although numbers are small, the results suggest that gonorrhoea therapy guideline adherence improved between 2009 and 2013.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.