Cancer risk communication, predictive testing and management in France, Germany, the Netherlands and the UK: general practitioners' and breast surgeons' current practice and preferred practice responsibilities

Irmgard Nippert; Claire Julian-Reynier; Hilary Harris; Gareth Evans; Christi J. van Asperen; Aad Tibben; Jörg Schmidtke

doi:10.1007/s12687-013-0173-x

General Practitioners and Breast Surgeons in France, Germany, Netherlands and the UK show variable breast cancer risk communication profiles

BMC Cancer ◽

10.1186/s12885-015-1281-2 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 5

Author(s):

Claire Julian-Reynier ◽

Anne-Deborah Bouhnik ◽

D Gareth Evans ◽

Hilary Harris ◽

Christi J van Asperen ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Risk Communication ◽

General Practitioners ◽

The Uk

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Current practice in treatment approach for bullous pemphigoid: comparison between national surveys from the Netherlands and the UK

Clinical and Experimental Dermatology ◽

10.1111/ced.12831 ◽

2016 ◽

Vol 41 (5) ◽

pp. 506-509 ◽

Cited By ~ 7

Author(s):

J. M. Meijer ◽

M. F. Jonkman ◽

F. Wojnarowska ◽

H. C. Wiliams ◽

G. Kirtschig

Keyword(s):

The Netherlands ◽

Bullous Pemphigoid ◽

Current Practice ◽

Treatment Approach ◽

National Surveys ◽

The Uk

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Epidemiology of Immune Thrombocytopenic Purpura in the United Kingdom, Germany, and the Netherlands.

Blood ◽

10.1182/blood.v106.11.5554.5554 ◽

2005 ◽

Vol 106 (11) ◽

pp. 5554-5554 ◽

Cited By ~ 2

Author(s):

Jessie A. Satia

Keyword(s):

United Kingdom ◽

The Netherlands ◽

General Practitioners ◽

Immune Thrombocytopenic Purpura ◽

Incidence Rates ◽

Data Availability ◽

Prevalence Rates ◽

Thrombocytopenic Purpura ◽

The Uk ◽

Over Time

Abstract Background: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder that is associated with serious clinical and health-related quality of life consequences. However, the true burden of ITP is not known because there is limited published data on its incidence and prevalence. Aims: To describe the incidence and prevalence of ITP over time among adults in selected European countries (United Kingdom, Germany, and the Netherlands) and to ascertain whether ITP incidence and prevalence differ by age or sex. Methods: ITP incidence and prevalence rates were calculated from three healthcare databases: the General Practitioners Research Database (UK), the IMS Disease Analyzer (UK and Germany), and the PHARMO Database (the Netherlands). These databases contain longitudinal patient medical record information from selected general practitioners and specialists, using samples designed to be representative of the countries of interest. Patient information is acquired through electronic linkages to providers’ practices in the GPRD and IMS Disease Analyzer, and through the Dutch National Medical Registry in PHARMO. The study periods were 1990–2000 (GPRD), 1994–2003 (IMS Disease Analyzer), and 1991–2003 (PHARMO); analyses were restricted to persons 19 years and older. ITP diagnoses were identified using the ICD-9-CM 287.3 and ICD-I0-CM D69.3 codes. Incidence rates as calculated include only first-time diagnoses whereas prevalence rates include all new and existing cases during a given year. Results: As shown in the table, average ITP incidence and prevalence rates during the study periods (10 years or more) were generally similar in the UK, Germany, and the Netherlands; for example, average incidence rates ranged from 0.6–3.0 per 100,000 persons/year. Although the differences were relatively minor, in general, incidence and prevalence appeared to be highest in Germany and lowest in the Netherlands. From all databases and years of study, persons 60 years and older had the highest age/sex-specific incidence and prevalence. Incidence and prevalence rates were also generally higher (7–36%) among women than men. ITP Incidence and Prevalence Among Adults in the UK, Germany, and the Netherlands Country Rates per 100,000 ** UK Incidence Prevalence ** Lowest and highest incidence and prevalence rates not necessarily for the same year; *** N/A = Not applicable GPRD: 1990–2000 Average 3.0 N/A*** Lowest 2.1 2.1 Highest 4.3 8.1 Most recent year of data availability 2.2 3.2 IMS Disease Analyzer: 1994–2003 Average 0.6 N/A*** Lowest 0.1 0.1 Highest 2.0 3.2 Most recent year of data availability (2003) 2.0 3.2 Germany IMS Disease Analyzer: 1994–2003 Average 2.7 N/A*** Lowest 1.7 2.8 Highest 5.1 7.3 Most recent year of data availability (2003) 2.0 3.5 The Netherlands PHARMO Database: 1992–2003 Average 1.9 Lowest 1.6 N/A*** Highest 2.1 1.9 Most recent year of data availability (2003) 2.1 2.4 2.4 Summary/Conclusions: During all study years, the incidence and prevalence of ITP in the UK, Germany, and the Netherlands was less than 10 per 100,000 persons/year and was relatively stable over time. ITP was more frequent among women and persons over 60 years of age. While studies derived from databases of medical records have potential limitations, such as disease misclassification, selection bias, or omissions/recording errors, our findings are consistent with other published investigations showing that ITP incidence and prevalence is fairly low in European countries.

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Current Practice of Testing for Hereditary Thrombophilia in the Netherlands.

Blood ◽

10.1182/blood.v108.11.3288.3288 ◽

2006 ◽

Vol 108 (11) ◽

pp. 3288-3288

Author(s):

Michiel Coppens ◽

Jan A. van Mourik ◽

Carel M. Eckmann ◽

Saskia Middeldorp

Keyword(s):

Cardiovascular Disease ◽

The Netherlands ◽

General Practitioners ◽

Pregnancy Complications ◽

Current Practice ◽

Factor V Leiden ◽

Factor V ◽

Test Results ◽

Therapeutic Consequences ◽

Thrombophilia Testing

Abstract Inherited thrombophilia is known to increase the risk for venous thromboembolism (VTE). Furthermore, an association between recurrent pregnancy loss and hypertensive pregnancy complications (including preeclampsia and HELLP syndrome) appears present. A relationship between thrombophilia and arterial cardiovascular disease could not be demonstrated in most studies. Since thrombophilia is prevalent in patients with VTE, testing for these abnormalities often reveals positive test results which may lead to widespread testing. This is also the case in patients with various other conditions. However, there is little convincing evidence about effectiveness of testing due to the uncertainty with respect to therapeutic consequences of a positive thrombophilia test results. To assess the current practice of thrombophilia testing in The Netherlands and to get an impression of the therapeutic implications of testing for patients, simple questionnaires were sent out to physicians that ordered tests for protein S, C, or antithrombin activity, factor V Leiden (or APC resistance) or the prothrombin 20210A mutation in 1998 consecutive individuals who were investigated between November 2003 and March 2004. The tests were performed in a laboratory that serves as a diagnostic facility for mainly non-academic hospitals and general practitioners throughout the Netherlands. Of a total of 1265 returned questionnaires, 1130 were suitable for analysis (response rate 63%). Of the tested individuals, 64% were female (median age 38 years, inter-quartile-range [IQR] 30–50) and 35% were male (median age 51, IQR 41–59). Tests were ordered by internists (37%), gynaecologists (20%), neurologists (15%) and general practitioners (13%). Only 42% of the tested individuals had experienced VTE, 23% arterial cardiovascular disease, and 17% had had pregnancy complications. A known carrier or VTE in the family was the reason for testing in 180 asymptomatic individuals (16%). Testing had had no therapeutic consequences in 869 tests (77%). In 32% of these patients, physicians stated that had the test revealed a thrombophilic defect, this would not have altered management of the patient. This study shows that testing for thrombophilia occurs very often in patients with various conditions. In the majority of cases, the results do not change therapeutic management of tested patients. Widespread thrombophilia testing is costly and may cause unnecessary concern in carriers. This study underscores the need to acquire high level evidence about its effectiveness that should include clinical outcomes as well as quality of life and costs.

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Towards two-way flood risk communication: current practice in a community in the UK

Journal of Water and Climate Change ◽

10.2166/wcc.2016.015 ◽

2016 ◽

Vol 7 (4) ◽

pp. 651-664 ◽

Cited By ~ 5

Author(s):

Neoh Siew Ping ◽

Uta Wehn ◽

Chris Zevenbergen ◽

Pieter van der Zaag

Keyword(s):

Risk Communication ◽

Flood Risk ◽

Current Practice ◽

Local Community ◽

Communication Strategies ◽

Community Resilience ◽

Flood Risk Management ◽

Flood Risks ◽

Research Findings ◽

The Uk

Despite the considerable progress in engineering works, flooding continues and is now recognized as a major and increasing challenge. This realisation has resulted in a shift in flood risk management from leaning heavily on structural measures to the incorporation of non-structural initiatives, such as communication about flood risks that is considerate of the diversity existing within communities and that encompasses the entire disaster cycle. Communities that are more aware of flood risks and possess the knowledge to prepare for disasters appear to be better able to respond, mitigate and recover from their detrimental impacts. This paper examines the current practice of flood risk communication strategies of a local community in Doncaster, UK. The research findings are analysed with a view to identifying factors that positively and negatively influence the flood risk communication strategies and community resilience. Based on these insights, we provide recommendations for further improving the communication about flood risks, and ways in which it could be better targeted and used throughout the disaster cycle to help strengthen community resilience.

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Asylum-seekers falsely implicating themselves in international crimes: Should they be informed of the existence of Article 1F of the Refugee Convention?

MIGRATION LETTERS ◽

10.33182/ml.v12i1.259 ◽

2014 ◽

Vol 12 (1) ◽

pp. 91-101

Author(s):

Brian Moore ◽

Joris van Wijk

Keyword(s):

The Netherlands ◽

Case Studies ◽

Asylum Seekers ◽

Refugee Convention ◽

International Crimes ◽

Refugee Claim ◽

The Uk ◽

National Governments

Case studies in the Netherlands and the UK of asylum applicants excluded or under consideration of exclusion pursuant to Article 1Fa of the Refugee Convention reveal that some applicants falsely implicated themselves in serious crimes or behaviours in order to enhance their refugee claim. This may have serious consequences for the excluded persons themselves, as well as for national governments dealing with them. For this reason we suggest immigration authorities could consider forewarning asylum applicants i.e. before their interview, about the existence, purpose and possible consequences of exclusion on the basis of Article 1F.

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