No abstract

An important disadvantage of most indicators of health related quality of life used in public health surveillance is their length. In this study the authors investigated the reliability and validity of a short indicator of health related quality of life, the Dutch version of the four item 'CDC Core Healthy Days Measures' (CDC HRQOL-4). The reliability was evaluated by calculating Cronbach's alpha of the CDC HRQOL-4. The concurrent validity was tested by comparing the CDC HRQOL-4 with three other indicators of health related quality of life, the SF-36, the WHOQoL-BREF and the GHQ-12. The construct validity was evaluated by assessing the ability of the CDC HRQOL-4 to discriminate between respondents with and without a (non-mental) chronic condition, depression, a visit to the general practitioner and use of prescription drugs. Randomly sampled respondents from the city of Utrecht were asked to fill in a questionnaire. 659 respondents (response rate 45%) completed the questionnaire. Participants represented the adult, non-institutionalised population of the city of Utrecht, the Netherlands: 58% women; mean age 41 years; 15% of non-Dutch origin. The reliability of the CDC HRQOL-4 was good. Cronbach's alpha of three of the four CDC HRQOL-4-items was 0.77 which is good for internal consistent scales. The concurrent validity was good. The four items of the CDC HRQOL-4 showed higher correlations with their corresponding domains of the other instrument than the other domains. Comparison of respondents with or without a chronic condition, depression, visit to the GP and use of prescription drugs produced evidence for an excellent construct validity of the CDC HRQOL-4.

BackgroundCow’s milk allergy (CMA) is the most common food allergy among infants. No data are available on the health care burden of suspected CMA in general practice. This study was conducted to evaluate the burden of suspected CMA in general practice (GP): (a) prevalence, (b) presenting symptoms, (c) diagnostic process, (d) guideline adherence, and (e) dietary measures.MethodsA retrospective cohort study was carried out in four Julius Healthcare Centers (JHCs). These JHCs form the core primary care academic network of the department of general practice of the University Medical Center of Utrecht. Electronic records of the first year of infants born May 2009 - April 2010 registered in the JHCs were screened for possible CMA suspicion. Preventive child healthcare (PCH) records were reviewed for additional information. Clinical presentation, diagnostic strategies and dietary measures were extracted.ResultsOf 804 infants evaluated, 55 presented with symptoms fitting the suspicion of CMA (prevalence of 7%). Presenting complaints involved the skin (71%); the gastrointestinal tract (60%); the respiratory tract (13%) or other symptoms (36%) and 23 infants presented with symptoms of two or more organ systems. In 31 children (56%) a food challenge was performed (n = 28 open and n = 3 double-blind). Open challenge test results were difficult to interpret due to inadequate implementation or reporting. None had confirmed CMA after an adequate challenge test. Long term milk substitute formulas were prescribed in 39 (71%) infants.ConclusionOn a yearly basis seven percent of children visit their GP for suspected CMA. A positive CMA diagnosis was rarely established after adequate implementation and reporting of diagnostics, yet long term dietary measures were prescribed in >70% of patients. There is definitely need for improvement of diagnosing CMA in primary care.

Local and regional policymakers, care providers and prevention workers involved in addiction and addiction care need timely and reliable information. As few data on substance use are available at a local or regional level, an integrated local or regional monitoring system for alcohol and drugs (MAD) was developed. The MAD consists of four modules: a local social and information map, analyses of registration data of (addiction) care organisations, a local/regional survey among the general population and a community-based drug monitoring system aimed at collecting data on hard drug users. Both quantitative and qualitative research methods are used. This paper presents an overview of the MAD results with respect to alcohol and illicit drug use. Both quantitative and qualitative results show a substantial variation between regions, even in a country as small as the Netherlands. The study shows that a monitoring system can be an important source of information for local addiction policy, care and prevention.

No abstract