Page 32 - 2015-09-01 AMC Steeneke.pptx

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e
2-propenal (acrolein)
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Name 2-propenal (acrolein)
2-butenal (crotonaldehyde)
trans-2-hexenal trans-2-octenal
Structure
Sources
red wine [1], tabacco smoke
Cinnamyl derivatives
With or without additional
2-butenal namaldehyd trans-2-hexenal
cassia 5-methyl-2-phenylhe 2-phenyl-2-alkenals (bark
Skilled professional care for pregnant women is not only important during childbirth, but also during the prenatal and postnatal period. In the prenatal period, professional care is generally acknowledged to be effective in preventing adverse pregnancy outcomes, and it is considered to be effective in detecting and treating complications, providing timely interventions, promoting a healthy lifestyle and facilitating informed choice [1]. In the postnatal period professional care is necessary to maintain and promote the health of mother and child, to
and
other
trans-2-octenal
graphic
Furfural derivatives
cacao, cofofestee,r an environment that offers help and support for physical and mental health meat prodaus cwtsell as social and cultural issues that can affect health and wellbeing.
Cinnamyl aldeh
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-2 oil) [1]
-e
nal
no
d
e
n-
co
njugated
e
double-bonds
tr(ans-cin replaced
crotonaldehyde)
x
Furfural
[2]
red wine [1], tabacco smoke [2]
banana [1], fig [17]
grape, orange
and other aromatic alkyl substituted aldehydes
Heterocyclic
General Introduction
population density [9]. Secondary and tertiary care is provided by obstetricians
and specialised ‘clinical’ midwives in general (secondary care) and academic 1 hospitals (tertiary care) [10].
One of the basic pillars of the Dutch maternity care system is risk selection. Risk selection is conducted at primary care level by only referring women and newborns with complications or an increased risk for developing complications to secondary care. Thus these primary maternity care professionals serve as gatekeepers to secondary maternity care. The basic principle behind risk selection is that in the Netherlands, pregnancy, childbirth and the postnatal period are in essence perceived as being ‘physiological’. By supervising low risk pregnancies,
Pagina afloop
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ie hy te
rague-Dawley rats were ex
posed to 2.5 o
[2]
red wine [1],
tabacco smoke
[2]
banana [1], fig
furoalnly important during Opmaak en vormgeving va
[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 care [12]. Between 1999 and 2012, the majority of pregnant women in the
Paginarand
[17]
grape, orange
fig [17], 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].
Heterocyclic
[1] Skilled professional care for pregnFaurnfutralwdeormivaet
non-western women in the Netherlands. In addition, information is given about
aromatic alkyl substituted aldehydes
2-alkylated aldehydes
trans-2-cis-6-nonadie nal 2-methylcrotonaldehy de
Furans with conjugation in side chain
Other sulphur containing substances
Furfurylidene-2-buta nal
2-(Methylthiomethyl) -3-phenylpropenal
2-phenyl-2-alke
n
eth
yl
-2
-p
ete
n
childbirth, but also during the prenatal and postnatal period. In the prenatal
cg
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
lifestyle and facilitating informed chOotihceer s[u1lp]h.uIrn the po2s-(tMneatthaylthpioemreiothdyl)professional
black tea [19]
containing substances -3-phenylpropenal
10
treating complications, providing timely interventions, promoting a healthy
Others
s
secondary care. Thus these primary maternity care professionals serve as
with or without additional double
tr
2
Others
additional
neral and geranial)
1.3
ADME (absorption, distribution, metabolism and excretion)
This introductory chapter provides background information on the organisation of Netherlands (83.2%) had their first maternity care check-up in a primary care
double-bonds
o
n
-c
on
e
s
met
ands cseovnefirraml aftoiollonwd-urpingvistihtse pinrewnahtiachl pdeiraiogndousntitci,l bcoiruthn.seItlincgonasnisdts hoefaaltnh inetdaukceataionnd
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ds
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x-2-enal
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General Introduction n uw proefschrift
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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
rp1ri5mary, sec
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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.
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non-western women’s prenatal and postnatal care utilisation in the Netherlands.
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mg/kg bw C labelled 2-propenal by gavage [23]. Urine was the major excretion route
Filling this gap in knowledge and understanding provided the main rationale for
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Approximately 77% of the 2444 midwives in the Netherlands provide this type of care [12]. Between 1999 and 2012, the majority of pregnant women in the
This introductory chapter provides background information on the organisation of
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non-western women in the Netherlands. In addition, information is given about
opmaak, keuze uit diverse lettertypen, persoonlijk ontwerp
in this thesis.
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
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In the Netherlands, maternity c primary, secondary and tertiary midwives, autonomous qualifie care on their own accountabili active in midwifery care. Latte
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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
ccording to the standards of the Royal Dutch
OV), the first prenatal visit (intake) should ideally be
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Bladerbare PDF € 150,- the needs and expectations of clients. In the first
eally be made, with an average of 13, depending on
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