Page 32 - 2019-06 presentatie LUMC

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cucumber [18] Furans with
period, professional care is generally acknowledged to be effective in preventing
conjugation in side
adverse pregnancy outcomes, and it is considered to bnealeffective in detecting and
chain
mg/kg bw
C labelled 2-propenal by gavage [23]. Urine was the major excretion rocuatre on their own accountability, and a small number of general practitioners active in midwifery care. Latter are mainly engaged in rural areas with a low
• •
conducting this study. The second rationale was gaining insight into the This thesis is specifically focusing on primary maternity care, with the
[2]
red wine [1],
tabacco smoke
[2]
[17]
grape, orange
[1]
cucumber [18]
black tea [19]
lime [1]
[21]
Furthermore, it offers new parents support for parenting and the responsibilities that come with it [2]. Despite these advantages and the universal accessibility of prenatal and postnatal care, previous studies in the Netherlands have demonstrated that non-western women from various ethnic origins are more likely to make inadequate use of these services [3-7].
Rnoesne-warecshtecrondwuocmteedns’sopfarer,nhaataslnaontdbepeonstanbaltealtocagrieveutailcisoamtiopnletine uthnedeNrestahnedrlianngdosf. Filling this gap in knowledge and understanding provided the main rationale for conducting this study. The second rationale was gaining insight into the interactions between non-western women and the maternity care professionals involved, as this may affect the utilisation of prenatal and postnatal care.
births and postnatal periods in primary maternity care, and only cases of (expected) complications/pathology in secondary maternity care, the various maternity care professionals’ expertise can be applied to its full potential [11]. To guide the risk selection, the indications for referral to and consultation of secondary care are defined in the List of Obstetric Indications (Verloskundige Indicatie Lijst) – a list based on scientific evidence and consensus among the pvaurbiolisuhsedmiante2r0n0it3y, iscainreusper.ofessionals. Currently the third revision of this list,
This thesis is specifically focusing on primary maternity care, with the abovementioned primary care midwives as the main care providers. Approximately 77% of the 2444 midwives in the Netherlands provide this type of
Paginarand
1
daard
banana [1], fig
citral (mixture of neral and geranial)
van uw proefschr care [12]. Between 1999 and 2012, the majority of pregnant women in the
1.3
[1]
ds within
24 hours.
Only trace amou
nt of trans-
2-nonenal or trans-2
-pentenal w
re in
th
eN
ethe
rl
ands
black tea [19]
lime [1] fig [17],
gatekeepers to secondary maternity care. The basic principle behinad rkisk seltecation is that in the l period are in
k
births and po only cases of (expected) co e, the various
aromatic alkyl substituted aldehydes
General Introduction
2-alkylated aldehydes
trans-2-cis-6-nonadie nal 2-methylcrotonaldehy de
Furans with conjugation in side chain
Furfurylidene-2-buta nal
2-phenyl-2-alke
n
eth
yl
-2
-p
ete
Other sulphur 2-(Methylthiomethyl) containing substances -3-phenylpropenal
childbirth, but also during the prenatal and postnatal period. In the prenatal
nity care
is organise
d in a mode
l consisting of so
called
activities are performed. According to the standards of the Royal Dutch Organisation of Midwives (KNOV), the first prenatal visit (intake) should ideally be made between the 6th and 8th week of pregnancy [14]. Throughout pregnancy 10 to 16 prenatal visits should ideally be made, with an average of 13, depending on necessary medical care and the needs and expectations of clients. In the first
treating complications, providing timely interventions, promoting a healthy
newborns with complications or an increa
e
d
risk for developing com
p
l
ications to
Others
lifestyle and facilitating informed chOotihceer s[u1lp]h.uIrn the po2s-(tMneatthaylthpioemreiothdyl)professional
32620 Reiko Kiwamoto.indd
11
17-03-15 15:34
with or without additional double
tr
2
Others
i
v
nFou ien al
circulation from the mgasteroaintesptinraol (dGIu) tcratcst, and were
aci
faeces [22]. In anoth[er2st1ud]y, male and female Sprague-Dawley rats were exposed to 2.5 or 15
on
n
i
s
rt
h
i
l
(
r
t
i
a
r
y
c
a
r
e
)
[
1
0
]
.
a
ls
-b
3-alkylated aldehydes
ds
nal
furoalnly important during Opmaak en vormgeving
ADME (absorption, distribution, metabolism and excretion)
ift
Heterocyclic
Skilled professional care for pregnFaurnfutralwdeormivaet
trans-2-trans-4-hexad ienal
fig [17], blueberry [20]
cacao,coffee, and specialise
‘clinical’ midwives in gener c
l birth (n
s
c
o
n
d
a
r
a
r
e
) and academic
e
s
met
o double-bonds
cg
n
n
-c
on
jug
a
ted
anis
ati
containing substances -3-phenylpropenal
foster an environment that offers help and support for physical and mental health
as well as social and cultural issues that can affect health and wellbeing.
essence perce
preg
na
n
cie
s,
5-
m
-phenylhe
ans-
e
t
h
y
x-2-enal
with or without
additional
double-bonds
Two or more
conjugated
double-bonds with or
without additional trans-2-trans-4-octad
2-
m
1.3 ADME (absorption, distribution, metabolism and excretion)
Furthermore, it offers new parents support for parenting and the responsibilities that come with it [2]. Despite these advantages and the universal accessibility of
l
-
Furfurylidene-2-buta
10
α,β-Unsaturated aldehydes are rapidly absorbed, distributed, metabolized and excreted in urine,
• koptekst
guide the risk selection, the indications for referral to and consultation of
prenatal and postnatal care, previous studies in the Netherlands have
maternity care professionals’ expertise can be applied to its full potential [11]. To
blueberry [20] faeces and expired air. When male Wistar rats were exposed to 100 mg/kg bw of 14C labelled demonstrated that non-western women from various ethnic origins are more
• paginacijfers
secondary care are defined in the List of Obstetric Indications (Verloskundige
trans-2-nonenal or trans-2-pentenal by gavage [22], both aldehydes entered the systemic likely to make inadequate use of these services [3-7].
• zijkant blokje
various maternity care professionals. Currently the third revision of this list,
Opmaak vanuit W
circulation from the gastrointestinal (GI) tract, and were metabolized to yield C-3 mercapturic acids within 24 hours. Only trace amount of trans-2-nonenal or trans-2-pentenal were found in
Indicatie Lijst) – a list based on scientific evidence and consensus among the
Research conducted so far, has not been able to give a complete understanding of
Filling this gap in knowledge and understanding provided the main rationale for
ord document
faeces [22]. In another study, male and female Sprague-Dawley rats were exposed to 2.5 or 15
published in 2003, is in use.
non-western women’s prenatal and postnatal care utilisation in the Netherlands.
Opmaak (linker-)
14
mg/kg bw C labelled 2-propenal by gavage [23]. Urine was the major excretion route
Standaard; professionele opmaak, enkele keuzes in vormgeving, excl omslag
interactions between non-western women and the maternity care professionals abovementioned primary care midwives as
the main care providers.
Custom; incl gesprek in Ede, professionele opmaak, keuze uit diverse lettertypen,
pe
rs
oonlijk ontwerp
and 34.2% gave birth in a primary care sebttainsgi[s1’.3].
This introductory chapter provides background information on the organisation of
Netherlands (83.2%) had their first maternity care check-up in a primary care
maternity care, the non-western population, perinatal and maternal mortality
Organisation of maternity care in the Netherlands
is organised in a mod re [8]. Primary care is medical professionals
and a small number re mainly engaged in
Non-western women in
setting. Eventually, 54.3% of the pregnant women started labour in primary care,
This introductory chapter provides background information on the organisation of Netherlands (83.2%) had their first maternity care check-up in a primary care
population density [9]. Secondary and tertiary care is provided by obstetricians
tting. E
faeces and expired air. When male Wistar rats were exposed to 100 mg/kg bw of 14C labeltlheedaim, research questions and theoretical framework of the research presented Primary midwifery care includes care provided during pregnancy (prenatal care),
4.3% o
a
hild
Prenatal care encompasses supervision of pregnant women from pregnancy cseovnefirraml aftoiollonwd-urpingvistihtse pinrewnahtiachl pdeiraiogndousntitci,l bcoiruthn.seItlincgonasnisdts hoefaaltnh inetdaukceataionnd
One of the basic pillars of the Dutch maternity care system is risk selection. Risk 811 Non-western women in maternity care in the Netherlands Chapter 1 9
selection is conducted at primary care level by only referring women and
se
α,β-Unsaturated aldehydes are rapidly absorbed, distributed, metabolized and excreted in urianmeo, ng non-western women and the utilisation of prenatal and postnatal care by and 34.2% gave birth in a primary care setting [13].
trans-2-nonenal or trans-2-pentenal by gavage [22], both
aldehydes entered the
in th
is thesis.
at
al c
are)
and
afte
r bir
th (p
ostn
ata
l/postpa
rtu
m ca
re
).
o
s
p
systemic
t
rlands, mater
14 midwives, autonomous qualified medical professionals providing full maternity
abo
liz
ed
to
y
a
s
t
iel
d
C-3
m
e
rca
pt
uOrir
e
ere fou
ma
non-western women in the Netherlands. In addition, information is given about
en s y
rted
terni
a
re,
n-
wes
ter
ula
tion
, pe
rina
tal a
ate
rna
ality
ty c d
the no
n pop
nd m
l mort
on of
ma
ter
nit
y ca
ndIninthe Nethe
primary, secondary and tertiary care [8]. Primary care is provided by primary care
s
secondary care. Thus these primary maternity care professionals serve as
3
2429
Boerlei
der.indd 9
21-02
-15 18
:47
titelpagina
ven (
tuall
y, 5 e
om
ft
he pre
gnan
tw
ta c
labo
ur in pr
imar
y care,
care is necessary to maintain and promote the health of mother and child, to
involved, as this may affect the utilisation of prenatal and postnatal care.
11 (op aanvraag):
Approximately 77% of the 2444 midwives in the Netherlands provide this type of
Zie voorbeeld
care [12]. Between 1999 and 2012, the majority of pregnant women in the
‘opmaak compleet
,-
ogramma
rofessionele floos of schreef)
tandaard peciale
omgeving
), the first prenatal visit (intake) should ideally be
32620 Reiko Kiwamoto.indd 11
17-03-15 15:34
am
non-western women in the Netherlands. In addition, information is given about the aim, research questions and theoretical framework of the research presented in this thesis.
on
gn
on
-w
e
s
te
rn
wo
me
n
and
t
he
utilisation of prenatal and postnatal care by
my.thesis mplications/pathology in 3segcroanfidasrcyhme autietrinnitgy ecna:r
P
Netherlands, pregnancy, childbirth and the postnata
ived as being ‘physiologic
al’.
By
supe
rv
isin
g low
ris
Primary midwifery care includes care provided during pregnancy (prenatal care), childbirth (natal care) and after birth (postnatal/postpartum care).
Prenatal care encompasses supervision of pregnant women from pregnancy confirmation during the prenatal period until birth. It consists of an intake and several follow-up visits in which diagnostic, counseling and health education
D
F
o
p
m
nl
a
stnatal periods in primary maternity care, and
Digitale publicatie
rding to the standards of the Royal Dutch
eek of pregnancy [14]. Throughout pregnancy 10
Bladerbare PDF € 150,- needs and expectations of clients. In the first
ly be made, with an average of 13, depending on
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9
In the Netherlands, maternity c primary, secondary and tertiary midwives, autonomous qualifie care on their own accountabili active in midwifery care. Latte
8
el consisting of so called provided by primary care providing full maternity of general practitioners rural areas with a low
maternity care in the Netherlands
activities are performed. A Organisation of Midwives (KN made between the 6th and 8t to 16 prenatal visits should id necessary medical care and
Chapter 1
9
32429 Boerleider.indd
cc OV h eal th
ar ca d ty,
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