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van der Pal-de Bruin KM de Walle HE de Rover CM Jeeninga W Cornel MC de Jong-van den Berg LT Buitendijk SE Paulussen TG 《Paediatric and perinatal epidemiology》2003,17(3):256-263
In The Netherlands, periconceptional folic acid use to prevent neural tube defects was promoted through a national 'Folic Acid Campaign'. In two regions, a local campaign supplemented the national campaign to increase the chances of reaching women with low socio-economic status (SES). A framework of outcome criteria, defined as awareness knowledge, perceived safety, attitudes and subjective norms, was developed to evaluate the effectiveness of the two local campaigns. Data were gathered by means of two cross-sectional studies conducted just before and 1 year after the campaigns took place. Before the campaigns were conducted, there were already differences in all effect criteria and folic acid use between women of different educational levels, mostly in favour of women with a high level of education. Although both educational campaigns appeared to have a positive impact on all outcome criteria, they failed to reduce the existing differences in these outcome criteria between women of different educational levels. Folic acid use can be promoted effectively by mass media campaigns, certainly in a large group of women with no prior knowledge of the health benefits associated with periconceptional folic acid use. However, in order to achieve more equal health outcomes among women of low and high SES, it seems that more tailored interventions for women of low SES are needed. 相似文献
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OBJECTIVE: To investigate the influence of ethnicity on the awareness and use of folic acid by pregnant women. DESIGN: Secondary data analysis. METHOD: Using the data on 1555 women, collected during a cross-sectional study conducted among pregnant women with good knowledge of the Dutch language in 1996, the authors determined what was known about the recommendation to use folic acid around the time of conception and what the actual use was. Women were defined as either 'western' or 'non-western' on the basis of the place of birth of the woman and her parents. RESULTS: Of the 1555 pregnant women, 74 (5%) were non-western or of non-western descent. Non-western women more often had a lower educational level than western women (51% versus 34%; p = 0.002) and more often had an unintended pregnancy (24% versus 8%; p < 0.0001). 41% of the non-western women had heard of the recommendation to use folic acid before pregnancy, compared to 79% of the western women (p < 0.0001). However, the use of folic acid was not significantly different between non-western and western women (56% versus 69%) if they had been aware of the recommendation to use folic acid before pregnancy. Awareness of the recommendation to use folic acid was higher in older women (OR: 1.46; 95% CI: 1.13-1.89), women of western descent (0.27; 0.16-0.47), women with a higher level of education (0.35; 0.27-0.45) and in case of planned pregnancy (0.45; 0.31-0.67). The use of folic acid, restricted to women who were aware of the recommendation to use folic acid before their pregnancy, was higher in older women (1.37; 1.05-1.80) and lower in those with more previous pregnancies (0.57; 0.43-0.75) and in case of an unplanned pregnancy (0.55; 0.34-0.88). CONCLUSION: Although non-western women had less knowledge of the recommendation to use folic acid than western women, the use of folic acid was not significantly different from that by western women if they had been aware of the recommendation to use folic acid before pregnancy. Continued education on folic acid targeting non-western and western women is important. 相似文献
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Jan H. Cornel Jeroen J. Bax Abdou Elhendy Ambroos E.M. Reijs Paolo M. Fioretti 《The international journal of cardiovascular imaging》1997,13(1):59-64
The aim of this study was to evaluate the value of thallium-201 chloride (201Tl) reinjection imaging following dobutamine stress (DRi) to identify viable myocardium in comparison with a rest-redistribution 201Tl protocol (RR). The identification of viable myocardium bears important consequences for adequate selection of patients with poor left ventricular function, often unable to exercise, who are considered for revascularization. Twenty-six patients with chronic coronary artery disease and depressed left ventricular function (ejection fraction 36±10%) were studied by both DRi and RR single photon emission computed tomography (SPECT). Semi-quantitative analysis of regional 201Tl activity (5-point score) and wall motion by echocardiography using a 16-segment model was performed. Regions were classified as viable (normal/reversible/fixed moderate defects) or non-viable (fixed severe defects) and related to regional wall motion. Target heart rate was reached in 25 patients. Myocardial viability was demonstrated in 353/416 (85%) by DRi SPECT and in 346/416 (83%) by RR SPECT. The agreement between the 2 protocols was 98% with a K-value of 0.94; similar results were obtained when the analysis was limited to dyscontractile segments. In conclusion, this study demonstrates the feasibility and diagnostic value of DRi SPECT to identify viable myocardium. 相似文献
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Kees Hendricksen Antoine G. van der Heijden Erik B. Cornel Henk Vergunst Theo M. de Reijke Erika van Boven Geert A. H. J. Smits Rajiv Puri Sigrid Gruijs J. Alfred Witjes 《World journal of urology》2009,27(3):337-342
Objectives To study the time-to-recurrence and duration of response in non-muscle invasive bladder cancer (NMIBC) patients, with a complete
ablative response after intravesical apaziquone instillations.
Methods Transurethral resection of bladder tumour(s) (TURBT) was performed in patients with multiple pTa-T1 G1-2 urothelial cell carcinoma
(UCC) of the bladder, with the exception of one marker lesion of 0.5–1.0 cm. Intravesical apaziquone was administered at weekly
intervals for six consecutive weeks, without maintenance instillations. A histological confirmed response was obtained 2–4 weeks
after the last instillation. Routine follow-up (FU) was carried out at 6, 9, 12, 18 and 24 months from the first apaziquone
instillation.
Results At 3 months FU 31 of 46 patients (67.4%) had a complete response (CR) to ablative treatment. Side-effects on the long-term
were only mild. Two CR patients dropped out during FU. On intention-to-treat (ITT) analysis 49.5% of the CR patients were
recurrence-free at 24 months FU, with a median duration of response of 18 months. Of 15 no response (NR) patients, only two
received additional prophylactic instillations after TURBT. On ITT-analysis 26.7% of the NR patients were recurrence-free
(log rank test, P = 0.155). The overall recurrence-free survival was 39% (18 of 46 patients) at 24 months FU.
Conclusions The CR of the marker lesion in 67% of patients was followed by a recurrence-free rate of 56.5% at 1-year FU, and 49.5% at
2-year FU. These long-term results are good in comparison with the results of other ablative studies. 相似文献