Risk Factors for Norovirus, Sapporo-like Virus, and Group A Rotavirus Gastroenteritis

Viral pathogens are the most common causes of gastroenteritis in the community. To identify modes of transmission and opportunities for prevention, a case-control study was conducted and risk factors for gastroenteritis attributable to norovirus (NV), Sapporo-like virus (SLV), and rotavirus were studied. For NV gastroenteritis, having a household member with gastroenteritis, contact with a person with gastroenteritis outside the household, and poor food-handling hygiene were associated with illness (population attributable risk fractions [PAR] of 17%, 56%, and 47%, respectively). For SLV gastroenteritis, contact with a person with gastroenteritis outside the household was associated with a higher risk (PAR 60%). For rotavirus gastroenteritis, contact with a person with gastroenteritis outside the household and food-handling hygiene were associated with a higher risk (PAR 86% and 46%, respectively). Transmission of these viral pathogens occurs primarily from person to person. However, for NV gastroenteritis, foodborne transmission seems to play an important role

Uptake of health services for common mental disorders by first-generation Turkish and Moroccan migrants in the Netherlands

Abstract Background Migration and ethnic minority status have been associated with higher occurrence of common mental disorders (CMD), while mental health care utilisation by non-Western migrants has been reported to be low compared to the general population in Western host countries. Still, the evidence-base for this is poor. This study evaluates uptake of mental health services for CMD and psychological distress among first-generation non-Western migrants in Amsterdam, the Netherlands. Methods A population-based survey. First generation non-Western migrants and ethnic Dutch respondents (N = 580) participated in structured interviews in their own languages. The interview included the Composite International Diagnostic Interview (CIDI) and the Kessler psychological distress scale (K10). Uptake of services was measured by self-report. Data were analysed using weighting techniques and multivariate logistic regression. Results Of subjects with a CMD during six months preceding the interview, 50.9% reported care for mental problems in that period; 35.0% contacted specialised services. In relation to CMD, ethnic groups were equally likely to access specialised mental health services. In relation to psychological distress, however, Moroccan migrants reported less uptake of primary care services (OR = 0.37; 95% CI = 0.15 to 0.88). Conclusion About half of the ethnic Dutch, Turkish and Moroccan population in Amsterdam with CMD contact mental health services. Since the primary purpose of specialised mental health services is to treat "cases", this study provides strong indications for equal access to specialised care for these ethnic groups. The purpose of primary care services is however to treat psychological distress, so that access appears to be lower among Moroccan migrants

Performance indicators for public mental healthcare: A systematic international inventory

Abstract Background The development and use of performance indicators (PI) in the field of public mental health care (PMHC) has increased rapidly in the last decade. To gain insight in the current state of PI for PMHC in nations and regions around the world, we conducted a structured review of publications in scientific peer-reviewed journals supplemented by a systematic inventory of PI published in policy documents by (non-) governmental organizations. Methods Publications on PI for PMHC were identified through database- and internet searches. Final selection was based on review of the full content of the publications. Publications were ordered by nation or region and chronologically. Individual PI were classified by development method, assessment level, care domain, performance dimension, diagnostic focus, and data source. Finally, the evidence on feasibility, data reliability, and content-, criterion-, and construct validity of the PI was evaluated. Results A total of 106 publications were included in the sample. The majority of the publications (n = 65) were peer-reviewed journal articles and 66 publications specifically dealt with performance of PMHC in the United States. The objectives of performance measurement vary widely from internal quality improvement to increasing transparency and accountability. The characteristics of 1480 unique PI were assessed. The majority of PI is based on stakeholder opinion, assesses care processes, is not specific to any diagnostic group, and utilizes administrative data sources. The targeted quality dimensions varied widely across and within nations depending on local professional or political definitions and interests. For all PI some evidence for the content validity and feasibility has been established. Data reliability, criterion- and construct validity have rarely been assessed. Only 18 publications on criterion validity were included. These show significant associations in the expected direction on the majority of PI, but mixed results on a noteworthy number of others. Conclusions PI have been developed for a broad range of care levels, domains, and quality dimensions of PMHC. To ensure their usefulness for the measurement of PMHC performance and advancement of transparency, accountability and quality improvement in PMHC, future research should focus on assessment of the psychometric properties of PI

Ethnic differences in the association between cardiovascular risk factors and psychological distress in a population study in the Netherlands

<p>Abstract</p> <p>Background</p> <p>There is growing body of evidence of an association between cardiovascular risk factors and depressive and anxiety symptoms. The purpose of this study was to investigate whether these associations are similar in ethnic minority groups.</p> <p>Methods</p> <p>A random urban population sample, aged 18+, stratified by ethnicity (484 native Dutch subjects, 383 Turkish-Dutch subjects, and 316 Moroccan-Dutch subjects), in Amsterdam, the Netherlands, was interviewed with the Kessler Psychological Distress scale (K10) in combination with measurements of several cardiovascular risk factors. The association of psychological distress (defined as a K10 score above cut-off of 20) with cardiovascular risk factors (obesity, abdominal obesity, hypertension, hypercholesterolemia, low HDL cholesterol levels or diabetes), ethnicity and their interaction was analyzed using logistic regression analyses, stratified by gender and adjusted for age.</p> <p>Results</p> <p>Cardiovascular risk factors were not significantly associated with psychological distress in any of the gender/ethnic groups, with the exception of a positive association of obesity and hypertension with psychological distress in native Dutch women and a negative association of hypertension and psychological distress in Turkish men. Interaction terms of cardiovascular risk factors and ethnicity were approaching significance only in the association of obesity with the K10 in women.</p> <p>Conclusion</p> <p>In this cross-sectional multi-ethnic adult population sample the majority of the investigated cardiovascular risk factors were not associated with psychological distress. The association of obesity with psychological distress varies by gender and ethnicity. Our findings indicate that the prevention of obesity and psychological distress calls for an integrated approach in native Dutch women, but not necessarily in Turkish-Dutch and Moroccan-Dutch women, in whom these problems may be targeted separately.</p