Researchers develop low-cost app to help combat fear of heights

Researchers in Amsterdam have developed an app to beat vertigo that they say is just as effective as a course of therapy. The app, known as ZeroPhobia, is based on the techniques of exposure therapy, a form of cognitive behaviour therapy (CBT) that gradually allows people to confront their fear of heights. Users create a VR headset by putting a smartphone in a cardboard holder and strapping it over their eyes. They then view a series of images that simulate the effect of looking down from heights. Researcher Tara Donker said the results were comparable to conventional therapy, but at a fraction of the cost. 'We can offer CBT for phobias without the intervention of a therapist, just with the patient's smartphone and a VR set that costs less than €10. 'Patients are gradually exposed in a VR environment to situations that they find frightening. In the case of vertigo, for example, they might stand on top of a tall building or on a balcony. In this way they learn step by step to cope with their fear.' She added: 'I think ZeroPhobia shows that stand-alone adaptations can help keep our health system affordable and make an important contribution to the quality of our care.' Details of the study have been published in the scientific journal JAMA Psychiatry.   More >

Dutch light up less, half overweight

The Dutch are smoking and drinking less, but official targets for improving health remain far off, national statistics office CBS and addiction monitor Trimbos Institute have found. The number of overweight people remained stable, with half of the Dutch population in the overweight category while 15% are classified as obese. The biggest decline is in the number of people who smoke. In 2014, 25.7% of the adult population were lighting up but this fell by over one percentage point to 22.4% in 2018. The number of people who drink too much (more than 14 units of alcohol a week for women and 21 for men, according to government guidelines) went down from almost 10% in 2014 to 9% in the same period. The number of heavy drinkers ( more than 4 units for women and six for men a day at least once week) remained the same. Some 35,000 people in the Netherlands a year die from the effects of smoking, being overweight or problem drinking. The Nationaal Preventieakkoord, a government prevention programme, aims to bring back the number of smokers and problem drinkers to 5% and the number of overweight people to 38% by 2040. The number of overweight and obese children has also remained stable between 2014 and 2018. Almost 12% of Dutch children between the ages of four and 18 are currently classified as overweight and 2.7% as obese.  More >

Period pain impacts third of women

One third of women can’t function normally during their period, a survey by the Radboud teaching hospital in Nijmegen among 42,000 women has found. Half of women who experience problems related to menstruation don’t talk about it, head researcher and gynaecologist Bertho Nieboer said. ‘They hide the fact that they have not been able to do certain things because of period pain, for instance. That means a condition may go untreated,’ he told broadcaster NOS.  A painful condition like endometriosis, or tissue growth outside the uterus, could go undetected and cause infertility, he warned. The most frequently mentioned problems by women are severe stomach ache, psychological problems, tiredness and back ache, Nieboer said. It is important women discuss the problem, gynaecologist Joke Schutte said. ‘You really don’t have to bring up your period pain at every birthday party you go to but if you are really suffering then that is not normal and you need to speak out,’ the broadcaster quotes her as saying. The survey, the biggest of its kind, may not represent all women in the Netherlands because it was conducted online and this may have caused selection bias. In other words those not experiencing problems less likely to participate in a survey, but it gives a good indication of the scale of the problems, the researchers said.  More >

Schools unable to deliver 24/7 smoking ban

Schools and universities are unsure whether they will be able to deliver a 24/7 tobacco ban on their premises which will become law from August 2020, the AD reports. Two thirds of secondary schools premises are currently smoke free as are 80% of primary school premises, according to research by the Trimbos Institute for mental health and addiction. However, only 14% of vocational schools (MBO) have banned smoking completely. The health ministry is also working on a change in the law which will make school boards liable for any infringements but although schools support the measure they feel policing it will be difficult. ‘Before you know it we will have the smoking police patrolling schoolyards,’ vocational schools council chairman Ton Heerts told the paper. Schools also say a 24/7 ban is unrealistic. ‘We can be asked to maintain the ban during the day but not when schools are closed at night. Bars and restaurants are spot checked but we have not had any assurances from the ministry that these checks will take place during the day,’ said Maurice Limmen, chairman of the HBO college council. Junior health minister Paul Blokhuis said he will be talking to schools about their responsibility to police the ban. ‘We understand there will be moments when it can be a problem because everyone will have gone home,’ he told the paper. The Dutch consumer product safety authority NVWA will be responsible for the checks but, the AD said, it is not clear how this will be done.  More >

Cost of hospital parking rises – survey

The cost of parking at hospitals has gone up in the past two years, according to research by discount website Fifteen institutions have increased their charges since the survey was last carried out in 2017. The most expensive place to visit sick friends and relatives is the OLVG-Oost in Amsterdam, where visitors pay €4 per hour. Utrecht was the most expensive province with an average fee of €2.05, while Noord-Holland also exceeded the €2 mark. Zeeland was the cheapest province for hospital parking at €0.67. Not all hospitals followed the trend: the AMC in Amsterdam, previously one of the most expensive places to park, has cut its charge from €3 per hour to €0.80 per half-hour or €10 for a day pass. The newly opened Ommelander hospital in Scheemda, Groningen, does not charge visitors, bringing the number of hospitals with free parking up to eight of the 90 surveyed.  More >

More foreign dentists are filling the gap

More foreign dentists are setting up in business in the Netherlands, partly due to the shortage of home grown graduates, Trouw said on Monday. Currently 17% of the country's 8,670 registered dentists are foreign, mainly from Germany, Belgium, Spain and Portugal, the paper said, quoting figures from Dutch dentistry association KNMT.  Zeeland has the most foreign dentists - 35% of the total. Every year, some 300 dentists retire but only 240 graduate from dental school, the KNMT says. The organisation wants the government to increase the number of places at dental school from 259 to 311, arguing that without action, the percentage of foreign dentists will increase to around 25%. Foreign dentists provide a far from ideal stop gap, KNMT chairman Wolter Brands told the paper. 'It is idiotic that the government is filling the gap with foreigners, he said. 'Most of them leave the country within five years but patients want a long term relationship with their dentist.' The health ministry told Trouw it does not consider the number of foreign dentists to be a problem, pointing out that they have to meet the same standards as Dutch ones.  More >

Healthcare market has gone 'too far'

The use of market forces in the healthcare system has gone too far and needs to be limited, health minister Hugo de Jonge says in an interview with Friday's AD. Without limits it will be too difficult to organise and pay for good care in the future, De Jonge said. For example, the 'absolute' right patients have to choose their own healthcare provider makes organising the system difficult and expensive, he said. New providers, often of dubious quality, are appearing all over the place and the tradition of paying by the hour encourages providers to drag out treatment processes. 'It is an unhealthy cocktail,' the minister told the AD. 'Healthcare needs less market and more alliances, otherwise we won't be able to keep going.' De Jonge says he wants to introduce tougher controls on new healthcare providers and to establish teams of district nurses who are no longer paid by the hour. He also plans to lobby Brussels to relax the rules on putting care contracts out to tender. Liberalisation The AD points out that the minister's comments are politically interesting, given that the CDA, his party, is in a coalition with two liberal parties which back market liberalisation. In addition, market forces were first introduced into the Dutch healthcare system by a CDA-led cabinet in 2006, which introduced competition between providers and allowed specialists to set their own fees. Understanding Nevertheless, De Jonge told the AD all parties understand that healthcare costs are rising and that the shortage of personnel is beginning to bite. That is why they will put their ideological convictions to one side and focus on practical solutions, he said. The minister's position is the third time in a few days that the government has taken action to stem market forces. Last week it emerged that the former state post monopoly PostNL is to merge with its only serious rival - with government backing. And earlier this week the government bought a stake in Air France-KLM to be better able to influence decisions made by the privatised airline group.  More >