Barriers to Health Care for Chinese in the Netherlands

This study examines utilisation of the Dutch health care system by Chinese people in the Netherlands as well as their attitudes to the system, paying special attention to mental health. Information was gathered by semistructured interviews (n = 102). The main issues investigated are access, help-seeking behaviour, and quality of care. Results showed that most respondents used Dutch health care as their primary method of managing health problems. Inadequate knowledge about the system and lack of Dutch language proficiency impede access to care, in particular registration with a General Practitioner (GP). Users complained that the care given differed from what they expected. Results also showed that the major problems are to be found in the group coming from the Chinese-speaking region. Western concepts of mental health appear to be widely accepted by Chinese in the Netherlands. However, almost half of our respondents believed that traditional Chinese medicine or other methods can also help with mental health problems. The provision of relevant information in Chinese appears to be important for improving access. Better interpretation and translation services, especially for first-generation migrants from the Chinese-speaking region, are also required

Clinical and pathological correlates of severity classifications in trigger fingers based on computer-aided image analysis

BACKGROUND: The treatment of trigger finger so far has heavily relied on clinicians’ evaluations for the severity of patients’ symptoms and the functionality of affected fingers. However, there is still a lack of pathological evidence supporting the criteria of clinical evaluations. This study’s aim was to correlate clinical classification and pathological changes for trigger finger based on the tissue abnormality observed from microscopic images. METHODS: Tissue samples were acquired, and microscopic images were randomly selected and then graded by three pathologists and two physicians, respectively. Moreover, the acquired images were automatically analyzed to derive two quantitative parameters, the size ratio of the abnormal tissue region and the number ratio of the abnormal nuclei, which can reflect tissue abnormality caused by trigger finger. A self-developed image analysis system was used to avoid human subjectivity during the quantification process. Finally, correlations between the quantitative image parameters, pathological grading, and clinical severity classification were assessed. RESULTS: One-way ANOVA tests revealed significant correlations between the image quantification and pathological grading as well as between the image quantification and clinical severity classification. The Cohen’s kappa coefficient test also depicted good consistency between pathological grading and clinical severity classification. CONCLUSIONS: The criteria of clinical classification were found to be highly associated with the pathological changes of affected tissues. The correlations serve as explicit evidence supporting clinicians in making a treatment strategy of trigger finger. In addition, our proposed computer-aided image analysis system was considered to be a promising and objective approach to determining trigger finger severity at the microscopic level

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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withdrawn 2017 hrs ehra ecas aphrs solaece expert consensus statement on catheter and surgical ablation of atrial fibrillation

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Suffering in silence? : The adequacy of Dutch mental health care provision for ethnic Chinese in the Netherlands

Compared to other ethnic groups in the Netherlands, Chinese are less likely to use mental health care yet present more serious symptoms at the first consultation. However, the reason for these differences is unknown because of the scarcity of research. This doctoral research sets out to fill this gap in our knowledge and to shed light on mental health care utilisation among this group. It further examines the adequacy of Dutch mental health care services for them. The research embraces a range of disciplines in medical and social sciences such as psychiatry, clinical and health psychology, medical anthropology, social history and sociology. Both literature reviews and empirical studies were carried out. Literature was examined relating to the background of Chinese in the Netherlands, general issues concerning health care for migrants, health service delivery and utilisation, as well as studies of Chinese in the Netherlands and other Western countries. In the empirical research a mixed-method approach was applied to data collection and analysis. Quantitative data were collected by administering a structured questionnaire in street interviews to 102 Chinese in the Randstad (Amsterdam, The Hague, Rotterdam and Utrecht). Qualitative data were collected using 23 in-depth interviews with Chinese who were willing to relate accounts of one or more Chinese persons in their social environment whom they regarded as having (had) mental health problems (精神問題). Results show that the Chinese studied regarded Dutch health care as their primary method of managing general and mental health problems. The beliefs they expressed about mental illness did not seem to differ from those current in the West in ways that would form a major barrier to seeking help from mainstream services. Although cultural differences were observed which might create barriers to mutual understanding between health professionals and Chinese care users, they were not such as to prevent Chinese from accepting and benefiting from Dutch health care. Despite the fact that health insurance in the Netherlands is compulsory but affordable, the expectation of high costs for mental health care sometimes affected the readiness of Chinese to use such services. The results of this research suggest that the main barriers have to do with more practical factors such as low Dutch proficiency, lack of knowledge of the health system, or language and communication problems. Other barriers include lack of cultural sensitivity among professionals and the failure of the health system to take steps to overcome these problems. Because Dutch mental health services are incorporated in both primary and secondary care, the barriers to mental and general health care utilisation often overlap. The study also showed that Chinese in the Netherlands form a heterogeneous group in terms of their origins, sub-cultures, migration patterns, socio-economic status and levels of integration. Different individuals have different needs. Service providers and policy makers should take the diversity of the Chinese group into account and pay more attention to issues such as communication barriers, knowledge of the health care system, attitudes of professionals and discrimination

Suffering in silence?: The adequacy of Dutch mental health care provision for ethnic Chinese in the Netherlands

Compared to other ethnic groups in the Netherlands, Chinese are less likely to use mental health care yet present more serious symptoms at the first consultation. However, the reason for these differences is unknown because of the scarcity of research. This doctoral research sets out to fill this gap in our knowledge and to shed light on mental health care utilisation among this group. It further examines the adequacy of Dutch mental health care services for them. The research embraces a range of disciplines in medical and social sciences such as psychiatry, clinical and health psychology, medical anthropology, social history and sociology. Both literature reviews and empirical studies were carried out. Literature was examined relating to the background of Chinese in the Netherlands, general issues concerning health care for migrants, health service delivery and utilisation, as well as studies of Chinese in the Netherlands and other Western countries. In the empirical research a mixed-method approach was applied to data collection and analysis. Quantitative data were collected by administering a structured questionnaire in street interviews to 102 Chinese in the Randstad (Amsterdam, The Hague, Rotterdam and Utrecht). Qualitative data were collected using 23 in-depth interviews with Chinese who were willing to relate accounts of one or more Chinese persons in their social environment whom they regarded as having (had) mental health problems (精神問題). Results show that the Chinese studied regarded Dutch health care as their primary method of managing general and mental health problems. The beliefs they expressed about mental illness did not seem to differ from those current in the West in ways that would form a major barrier to seeking help from mainstream services. Although cultural differences were observed which might create barriers to mutual understanding between health professionals and Chinese care users, they were not such as to prevent Chinese from accepting and benefiting from Dutch health care. Despite the fact that health insurance in the Netherlands is compulsory but affordable, the expectation of high costs for mental health care sometimes affected the readiness of Chinese to use such services. The results of this research suggest that the main barriers have to do with more practical factors such as low Dutch proficiency, lack of knowledge of the health system, or language and communication problems. Other barriers include lack of cultural sensitivity among professionals and the failure of the health system to take steps to overcome these problems. Because Dutch mental health services are incorporated in both primary and secondary care, the barriers to mental and general health care utilisation often overlap. The study also showed that Chinese in the Netherlands form a heterogeneous group in terms of their origins, sub-cultures, migration patterns, socio-economic status and levels of integration. Different individuals have different needs. Service providers and policy makers should take the diversity of the Chinese group into account and pay more attention to issues such as communication barriers, knowledge of the health care system, attitudes of professionals and discrimination

Curcumin Inhibits LIN-28A through the Activation of miRNA-98 in the Lung Cancer Cell Line A549

[[abstract]]Metastasis is common in lung cancer and is associated with poor clinical outcomes and increased mortality. Curcumin is a natural anti-cancer agent that inhibits the metastasis of various cancers by modulating the expression of micro (mi) RNAs such as miR-98, which acts as a tumor suppressor. This study investigated the effect of curcumin on miR-98 expression and in vitro cell line growth and invasiveness in lung cancer. Curcumin treatment enhanced the expression of miR-98 and reduced that of the miR-98 target gene LIN28A as well as matrix metalloproteinase (MMP) 2 and MMP9 in vitro and in vivo. MiR-98 overexpression suppressed lung cancer cell migration and invasion by inhibiting LIN28A-induced MMP2 and MMP9 expression. Meanwhile, LIN28A level was downregulated by overexpression of miR-98 mimic. Induction of miR-98 by curcumin treatment suppressed MMP2 and MMP9 by targeting LIN28A. These findings provide insight into the mechanisms by which curcumin suppresses lung cancer cell line growth in vitro and in vivo and invasiveness in vitro. Curcumin Inhibits LIN-28A through the Activation of miRNA-98 in the Lung Cancer Cell Line A549 (PDF Download Available). Available from: https://www.researchgate.net/publication/317377715_Curcumin_Inhibits_LIN-28A_through_the_Activation_of_miRNA-98_in_the_Lung_Cancer_Cell_Line_A549 [accessed Oct 30 2017]