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In 1998, a regional cardiovascular diseases prevention program was started in The Netherlands. This paper presents the design and results of a process study on the community intervention. The main purpose of the study was to gain insight into the reasons why expected effects were or were not achieved. Data was collected using multiple data sources and/or methods to measure indicators of intervention implementation. The results indicate that the community analysis and the subsequent organization of nine local Health Committees had been satisfactory. However, some factors that might influence the actual functioning of the Health Committees could be improved. Furthermore, the expert training for the members of these Committees had not yet been carried out as planned and there were doubts about the added value of collaboration with experts thus far. Environmental strategies were felt to need more attention and ensuring long-term continuation requires continuous effort. Most of the 293 intervention activities had focused on nutrition, while smoking cessation activities had been given lowest priority. It is concluded that the process evaluation has provided information about successful and less successful elements of the community intervention. [ABSTRACT FROM AUTHOR]

In communities with an increased prevalence of hereditary deafness, social, and linguistic adaptations are found in response. Aulbers (1959) describes a high prevalence of deafness in a fishing village on the Dutch coast: Katwijk aan Zee. This article aims to assess the current prevalence of deafness in Katwijk, as well as the current sign language situation there. To this end, data were collected from various sources, including governmental studies on public health, archives, a genealogical database and interviews with deaf inhabitants of Katwijk. The various types of data confirm the presence of a higher prevalence of deafness in Katwijk that continues to date. Linguistic and anthropological research is needed to establish to what extent this has affected the experience and position of deaf people and their sign language usage in Katwijk. [ABSTRACT FROM AUTHOR]

Background: Provision of adequate care for the oldest old is increasingly crucial, given the current ageing trends. This study explores differences in end-of-life care of the oldest (≥85 years) versus the younger (65–84 years) old; testing the hypothesis that age could be an independent correlate of receiving specialised palliative care services (SPCS), having palliative-centred treatment and dying in a preferred place.Methods: general practitioners (GPs) participating in the nation-wide representative network in the Netherlands were asked to fill in patient, illness and care characteristics of all registered patients ≥65 years, who died non-suddenly in their practices between 2005 and2008, using standardised forms. Associations with the palliative care variables were tested using multiple logistic regression.Results: nine hundred and ninety patients were registered. Among the oldest old, there were more women than men, more patients with heart failure than cancer, less hospital and home deaths and more residential care home deaths compared with the younger old. Of the oldest old, fewer received SPCS and more preferred to die in a residential care home than the younger old. Age was independently associated with palliative care provided: compared with the younger group, the oldest old received SPCS less often (OR = 0.7) and were treated with a palliative-centred goal more often (OR = 2.4); but age was not related to dying in a preferred place, i.e. independent of other characteristics.Conclusion: this study shows age to be independently associated with receiving SPCS in the Dutch community. Although the GPs do recognise the ‘palliative phase’ in the oldest old, involvement of specialist teams is somewhat less. [ABSTRACT FROM AUTHOR]