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Durão S, Wilkinson M, Davids EL, Gerritsen A, Kredo T. Effects of policies or interventions that influence the school food environment on children's health and nonhealth outcomes: a systematic review. Nutr Rev 2024; 82:332-360. [PMID: 37253393 PMCID: PMC10859694 DOI: 10.1093/nutrit/nuad059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
CONTEXT Globally, 1 in 3 children under 5 years is undernourished or overweight, and 1 in 2 suffers from hidden hunger due to nutrient deficiencies. As children spend a considerable time at school, school-based policies that aim to improve children's dietary intake may help address this double burden of malnutrition. OBJECTIVE This systematic review aimed to assess the effects of implementing policies or interventions that influence the school food environment on children's health and nonhealth outcomes. DATA SOURCES, EXTRACTION, AND ANALYSIS Eleven databases were searched up to April 2020 and the World Health Organization (WHO) released a call for data due in June 2020. Records were screened against the eligibility criteria, and data extraction and risk-of-bias assessment were conducted by 1 reviewer and checked by another. The synthesis was based on effect direction, and certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. CONCLUSIONS Seventy-four studies reporting 10 different comparisons were included. The body of evidence indicates that interventions addressing the school food environment may have modest beneficial effects on certain key outcomes. Nutrition standards for healthy foods and beverages at schools, interventions that change how food is presented and positioned, and fruit and vegetable provision may have a beneficial effect on the consumption of healthy foods and beverages. Regarding effects on the consumption of discretionary foods and beverages, nutrition standards may have beneficial effects. Nutrition standards for foods and beverages, changes to portion size served, and the implementation of multiple nudging strategies may have beneficial effects on energy intake. Regarding effects of purchasing or selecting healthier foods, changes to how food is presented and positioned may be beneficial. This review was commissioned and supported by the WHO (registration 2020/1001698-0). WHO reviewed and approved the protocol for the systematic review and reviewed the initial report of the completed systematic review. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no: CRD42020186265.
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Affiliation(s)
- Solange Durão
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Maryke Wilkinson
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Better Health Programme South Africa, Mott MacDonald, Cape Town, South Africa
| | - Eugene L Davids
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Child and Adolescent Psychiatry, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Annette Gerritsen
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine and Division of Epidemiology and Biostatistics, and Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
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Dewidar O, Lotfi T, Langendam M, Parmelli E, Saz Parkinson Z, Solo K, Chu DK, Mathew JL, Akl EA, Brignardello-Petersen R, Mustafa RA, Moja L, Iorio A, Chi Y, Canelo-Aybar C, Kredo T, Karpusheff J, Turgeon AF, Alonso-Coello P, Wiercioch W, Gerritsen A, Klugar M, Rojas MX, Tugwell P, Welch VA, Pottie K, Munn Z, Nieuwlaat R, Ford N, Stevens A, Khabsa J, Nasir Z, Leontiadis GI, Meerpohl JJ, Piggott T, Qaseem A, Matthews M, Schünemann HJ. Which actionable statements qualify as good practice statements In Covid-19 guidelines? A systematic appraisal. BMJ Evid Based Med 2022; 27:361-369. [PMID: 35428695 PMCID: PMC9044517 DOI: 10.1136/bmjebm-2021-111866] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate the development and quality of actionable statements that qualify as good practice statements (GPS) reported in COVID-19 guidelines. DESIGN AND SETTING Systematic review . We searched MEDLINE, MedSci, China National Knowledge Infrastructure (CNKI), databases of Grading of Recommendations Assessment, Development and Evaluation (GRADE) Guidelines, NICE, WHO and Guidelines International Network (GIN) from March 2020 to September 2021. We included original or adapted recommendations addressing any COVID-19 topic. MAIN OUTCOME MEASURES We used GRADE Working Group criteria for assessing the appropriateness of issuing a GPS: (1) clear and actionable; (2) rationale necessitating the message for healthcare practice; (3) practicality of systematically searching for evidence; (4) likely net positive consequences from implementing the GPS and (5) clear link to the indirect evidence. We assessed guideline quality using the Appraisal of Guidelines for Research and Evaluation II tool. RESULTS 253 guidelines from 44 professional societies issued 3726 actionable statements. We classified 2375 (64%) as GPS; of which 27 (1%) were labelled as GPS by guideline developers. 5 (19%) were labelled as GPS by their authors but did not meet GPS criteria. Of the 2375 GPS, 85% were clear and actionable; 59% provided a rationale necessitating the message for healthcare practice, 24% reported the net positive consequences from implementing the GPS. Systematic collection of evidence was deemed impractical for 13% of the GPS, and 39% explained the chain of indirect evidence supporting GPS development. 173/2375 (7.3%) statements explicitly satisfied all five criteria. The guidelines' overall quality was poor regardless of the appropriateness of GPS development and labelling. CONCLUSIONS Statements that qualify as GPS are common in COVID-19 guidelines but are characterised by unclear designation and development processes, and methodological weaknesses.
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Affiliation(s)
- Omar Dewidar
- Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Miranda Langendam
- Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Elena Parmelli
- Joint Research Centre, European Commission, Ispra, Italy
| | - Zuleika Saz Parkinson
- Instituto de Salud Carlos III, Agencia de Evaluación de Tecnologías Sanitarias, Madrid, Spain
| | - Karla Solo
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Derek K Chu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Joseph L Mathew
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
| | - Reem A Mustafa
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Internal Medicine, Division of Nephrology and Hypertension, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Lorenzo Moja
- Department of Health Product Policy and Standards, World Health Organization, Geneve, Switzerland
| | - Alfonso Iorio
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Yuan Chi
- Yealth Network, Beijing Yealth Technology Co., Ltd, Beijing, China
- Cochrane Campbell Global Ageing Partnership, London, UK
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau-CIBERESP, Barcelona, Spain
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, Western Cape, South Africa
- Clinical Pharmacology, Department of Medicine, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | | | - Alexis F Turgeon
- Centre de Recherche du Centre Hospitalier Affilié Universitaire de Québec (CHA), CHA-Hôpital de l'Enfant-Jésus, Université Laval, Quebec, Quebec, Canada
- Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec City, Québec, Canada
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau-CIBERESP, Barcelona, Spain
| | - Wojtek Wiercioch
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Annette Gerritsen
- Cochrane South Africa, South African Medical Research Council, Cape Town, Western Cape, South Africa
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - María Ximena Rojas
- Department of Clinical Epidemiology and Public Health, Institut d'Investigació Biomèdica Sant Pau IIB Sant Pau, Barcelona, Spain
| | - Peter Tugwell
- Department of Medicine, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Vivian Andrea Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Kevin Pottie
- Deparatment of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Zachary Munn
- Joanna Briggs Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Robby Nieuwlaat
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nathan Ford
- Department of HIV, Hepatitis and Sexually Transmitted Infections, World Health Organization, Geneva, Switzerland
| | - Adrienne Stevens
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
| | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Zil Nasir
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
| | - Grigorios I Leontiadis
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Joerg J Meerpohl
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
- Medical Center - University of Freiburg, Institute for Evidence in Medicine, Freiburg, Germany
| | - Thomas Piggott
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Amir Qaseem
- American College of Physicians, Philadelphia, Pennsylvania, USA
| | - Micayla Matthews
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Cochrane Canada, Hamilton, Ontario, Canada
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3
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Hulst R, Gorter J, Obeid J, Voorman J, van Rijssen I, Gerritsen A, Visser-Meily J, Pillen S, Verschuren O. Accelerometer-measured physical activity, sedentary behaviour, and sleep in children with cerebral palsy and their adherence to the 24-hour activity guidelines. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Kroon VJ, Daamen LA, Tseng DSJ, de Vreugd AR, Brada LJH, Busch OR, Derksen TC, Gerritsen A, Rombouts SJE, Smits FJ, Walma MS, Wennink RAW, Besselink MG, van Santvoort HC, Molenaar IQ. Pancreatic exocrine insufficiency following pancreatoduodenectomy: A prospective bi-center study. Pancreatology 2022; 22:1020-1027. [PMID: 35961936 DOI: 10.1016/j.pan.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 06/06/2022] [Accepted: 08/01/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Pancreatic exocrine insufficiency (PEI) is a common complication following pancreatoduodenectomy (PD) leading to malnutrition. The course of PEI and related symptoms and vitamin deficiencies is unknown. This study aimed to assess the (long-term) incidence of PEI and vitamin deficiencies after PD. METHODS A bi-centre prospective observational cohort study was performed, including patients who underwent PD for mainly pancreatic and periampullary (pre)malignancies (2014-2018). Two cohorts were formed to evaluate short and long-term results. Patients were followed for 18 months and clinical symptoms were evaluated by questionnaire. PEI was based on faecal elastase-1 (FE-1) levels and/or clinical symptoms. RESULTS In total, 95 patients were included. After three months, all but three patients had developed PEI and 27/29 (93%) patients of whom stool samples were available showed abnormal FE-1 levels, which did not improve during follow-up. After six months, all patients had developed PEI. During follow-up, symptoms resolved in 35%-70% of patients. Vitamin D and K deficiencies were observed in 48%-79% of patients, depending on the moment of follow-up; 0%-50% of the patients with deficiencies received vitamin supplementation. DISCUSSION This prospective study found a high incidence of PEI after PD with persisting symptoms in one-to two thirds of all patients. Limited attention was paid to vitamin deficiencies. Improved screening and treatment strategies for PEI and vitamins need to be designed.
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Affiliation(s)
- V J Kroon
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - L A Daamen
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands; Dept. of Radiation Oncology, UMC Utrecht Cancer Center, Utrecht University, Utrecht, the Netherlands
| | - D S J Tseng
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - A Roele- de Vreugd
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - L J H Brada
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - O R Busch
- Dept. of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - T C Derksen
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - A Gerritsen
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - S J E Rombouts
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - F J Smits
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - M S Walma
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - R A W Wennink
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - M G Besselink
- Dept. of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - H C van Santvoort
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands
| | - I Q Molenaar
- Dept. of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, the Netherlands.
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Dewidar O, Lotfi T, Langendam MW, Parmelli E, Saz Parkinson Z, Solo K, Chu DK, Mathew JL, Akl EA, Brignardello-Petersen R, Mustafa RA, Moja L, Iorio A, Chi Y, Canelo-Aybar C, Kredo T, Karpusheff J, Turgeon AF, Alonso-Coello P, Wiercioch W, Gerritsen A, Klugar M, Rojas MX, Tugwell P, Welch VA, Pottie K, Munn Z, Nieuwlaat R, Ford N, Stevens A, Khabsa J, Nasir Z, Leontiadis G, Meerpohl J, Piggott T, Qaseem A, Matthews M, Schünemann HJ. Good or best practice statements: proposal for the operationalisation and implementation of GRADE guidance. BMJ Evid Based Med 2022; 28:189-196. [PMID: 35428694 DOI: 10.1136/bmjebm-2022-111962] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 02/05/2023]
Abstract
An evidence-based approach is considered the gold standard for health decision-making. Sometimes, a guideline panel might judge the certainty that the desirable effects of an intervention clearly outweigh its undesirable effects as high, but the body of supportive evidence is indirect. In such cases, the application of the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach for grading the strength of recommendations is inappropriate. Instead, the GRADE Working Group has recommended developing ungraded best or good practice statement (GPS) and developed guidance under which circumsances they would be appropriate.Through an evaluation of COVID-1- related recommendations on the eCOVID Recommendation Map (COVID-19.recmap.org), we found that recommendations qualifying a GPS were widespread. However, guideline developers failed to label them as GPS or transparently report justifications for their development. We identified ways to improve and facilitate the operationalisation and implementation of the GRADE guidance for GPS.Herein, we propose a structured process for the development of GPSs that includes applying a sequential order for the GRADE guidance for developing GPS. This operationalisation considers relevant evidence-to-decision criteria when assessing the net consequences of implementing the statement, and reporting information supporting judgments for each criterion. We also propose a standardised table to facilitate the identification of GPS and reporting of their development. This operationalised guidance, if endorsed by guideline developers, may palliate some of the shortcomings identified. Our proposal may also inform future updates of the GRADE guidance for GPS.
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Affiliation(s)
- Omar Dewidar
- Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Miranda W Langendam
- Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Elena Parmelli
- Joint Research Centre, European Commission, Ispra, Lombardia, Italy
| | - Zuleika Saz Parkinson
- Instituto de Salud Carlos III, Agencia de Evaluación de Tecnologías Sanitarias, Madrid, Spain
| | - Karla Solo
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
| | - Derek K Chu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Joseph L Mathew
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
| | - Reem A Mustafa
- Internal Medicine, Division of Nephrology and Hypertension, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Lorenzo Moja
- Department of Health Product Policy and Standards, World Health Organization, Geneva, Switzerland
| | - Alfonso Iorio
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Yuan Chi
- Yealth Network, Beijing Yealth Technology Co., Ltd, Beijing, China
- Cochrane Campbell Global Ageing Partnership, London, UK
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau-CIBERESP, Barcelona, Spain
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Clinical Pharmacology, Department of Medicine, Stellenbosch University, Cape Town, South Africa
| | | | - Alexis F Turgeon
- Centre de Recherche du Centre Hospitalier Affilié Universitaire de Québec (CHA), CHA-Hôpital de l'Enfant-Jésus, Université Laval, Québec City, Québec, Canada
- Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec City, Québec, Canada
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau-CIBERESP, Barcelona, Spain
| | - Wojtek Wiercioch
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Annette Gerritsen
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - María Ximena Rojas
- Department of Clinical Epidemiology and Public Health, Institut d'Investigació Biomèdica Sant Pau IIB Sant Pau, Barcelona, Spain
| | - Peter Tugwell
- Department of Medicine, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Vivian Andrea Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Kevin Pottie
- Deparatment of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Zachary Munn
- Joanna Briggs Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Robby Nieuwlaat
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Nathan Ford
- Department of HIV, Hepatitis and Sexually Transmitted Infections, World Health Organization, Geneva, Switzerland
| | - Adrienne Stevens
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
| | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Zil Nasir
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Grigorios Leontiadis
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Joerg Meerpohl
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
- Medical Center - University of Freiburg, Institute for Evidence in Medicine, Freiburg, Germany
| | - Thomas Piggott
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Amir Qaseem
- American College of Physicians, Philadelphia, Pennsylvania, USA
| | - Micayla Matthews
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, Canada
- WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences Humanitas University, Humanitas University, Milan, Italy
- Cochrane Canada, Hamilton, Ontario, Canada
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Hauss A, Loos C, Gerritsen A, Urschel K, Pagan J. 61 Effect of branched-chain amino acid and N-acetylcysteine supplementation post-exercise on muscle mTOR signaling in exercising horses. J Equine Vet Sci 2021. [DOI: 10.1016/j.jevs.2021.103524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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George G, Cawood C, Puren A, Khanyile D, Gerritsen A, Govender K, Beckett S, Glenshaw M, Diallo K, Ayalew K, Gibbs A, Reddy T, Madurai L, Kufa-Chakezha T, Kharsany ABM. Evaluating DREAMS HIV prevention interventions targeting adolescent girls and young women in high HIV prevalence districts in South Africa: protocol for a cross-sectional study. BMC Womens Health 2020; 20:7. [PMID: 31948429 PMCID: PMC6966796 DOI: 10.1186/s12905-019-0875-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/27/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Young women in sub-Saharan Africa remain at the epicentre of the HIV epidemic, with surveillance data indicating persistent high levels of HIV incidence. In South Africa, adolescent girls and young women (AGYW) account for a quarter of all new HIV infections. Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) is a strategy introduced by the United States President's Emergency Plan for AIDS Relief (PEPFAR) aimed at reducing HIV incidence among AGYW in 10 countries in sub-Saharan Africa by 25% in the programme's first year, and by 40% in the second year. This study will assess the change in HIV incidence and reduction in risk associated behaviours that can be attributed to the DREAMS initiative in South Africa, using a population-based cross-sectional survey. METHODS Data will be collected from a household-based representative sample of AGYW (between the ages 12-24 years) in four high prevalence districts (more than 10% of the population have HIV in these districts) in South Africa in which DREAMS has been implemented. A stratified cluster-based sampling approach will be used to select eligible participants for a cross-sectional survey with 18,500, to be conducted over 2017/2018. A questionnaire will be administered containing questions on sexual risk behaviour, selected academic and developmental milestones, prevalence of gender based violence, whilst examining exposure to DREAMS programmes. Biological samples, including two micro-containers of blood and self-collected vulvovaginal swab samples, are collected in each survey to test for HIV infection, HIV incidence, sexually transmitted infections (STIs) and pregnancy. This study will measure trends in population level HIV incidence using the Limiting antigen (LAg) Avidity Enzyme Immuno-Assay (EIA) and monitor changes in HIV incidence. DISCUSSION Ending the HIV/AIDS pandemic by 2030 requires the continual monitoring and evaluation of prevention programmes, with the aim of optimising efforts and ensuring the achievement of epidemic control. This study will determine the impact DREAMS interventions have had on HIV incidence among AGYW in a 'real world, non-trial setting'.
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Affiliation(s)
- Gavin George
- Health Economics and HIV and AIDS Research Division (HEARD), 4th Floor, J Block, Westville Campus, University of KwaZulu-Natal, Durban, South Africa
| | - Cherie Cawood
- Epicentre AIDs Risk Management (Pty) Limited, Paarl, South Africa
| | - Adrian Puren
- Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service (NICD/NHLS), Johannesburg, South Africa
| | - David Khanyile
- Epicentre AIDs Risk Management (Pty) Limited, Paarl, South Africa
| | | | - Kaymarlin Govender
- Health Economics and HIV and AIDS Research Division (HEARD), 4th Floor, J Block, Westville Campus, University of KwaZulu-Natal, Durban, South Africa
| | - Sean Beckett
- Health Economics and HIV and AIDS Research Division (HEARD), 4th Floor, J Block, Westville Campus, University of KwaZulu-Natal, Durban, South Africa.
| | - Mary Glenshaw
- U.S. Centers for Disease Control and Prevention (CDC), Pretoria, South Africa
| | - Karidia Diallo
- U.S. Centers for Disease Control and Prevention (CDC), Pretoria, South Africa
| | - Kassahun Ayalew
- U.S. Centers for Disease Control and Prevention (CDC), Pretoria, South Africa
| | - Andrew Gibbs
- Health Economics and HIV and AIDS Research Division (HEARD), 4th Floor, J Block, Westville Campus, University of KwaZulu-Natal, Durban, South Africa.,Gender and Health Research Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa
| | - Tarylee Reddy
- Biostatistics Research Unit, South African Medical Research Council (SAMRC), Durban, South Africa
| | - Lorna Madurai
- Global Clinical and Virology Laboratory, Amanzimtoti, Durban, South Africa
| | - Tendesayi Kufa-Chakezha
- Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service (NICD/NHLS), Johannesburg, South Africa
| | - Ayesha B M Kharsany
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
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Visser A, van der Maarel-Wierink CD, Janssens B, Niesten D, Jerković-Ćosić K, Duyck J, Gerritsen A, Hollaar V, Krausch-Hofmann S, van der Putten GJ, Weijenberg RAF, Listl S, Lobbezoo F, Schols JMGA, Bruers JJM. [Research agenda oral care for older people in the Netherlands and Flanders (Belgium)]. Ned Tijdschr Tandheelkd 2019; 126:637-645. [PMID: 31840674 DOI: 10.5177/ntvt.2019.12.19085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Oral care for older people is an underexposed topic in dentistry as well as in general healthcare, while oral care professionals are increasingly confronted with frail and multimorbid older people with complex care needs. The research agenda 'Oral care for the elderly' was developed to encourage the collaboration of researchers in the Netherlands and Flanders (Belgium) to do more research in this area and in this way, to achieve an expansion and implementation of knowledge. This will make possible the provision of a socially responsible and robust basis for sustainable oral care for frail older people. The focus of the agenda is on 3 themes, namely oral health and oral function for older people; multi/interdisciplinary collaboration within primary care and the costs, benefits and long-term effect(s) of oral care throughout the entire course of life. This article provides an overview of this research agenda and the way in which it has been established.
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Stratton S, Gerritsen A, Loos C, Urschel K. Effect of forage type and ration balancer protein content on measures of whole-body protein metabolism in growing horses consuming a predominantly forage diet. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Loos C, Dorsch S, Gerritsen A, Urschel K. Effects of dietary protein level on muscle protein signaling pathways in horses. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Loos C, Dorsch S, Gerritsen A, Barnes T, Urschel K. PSXIII-10 Effects of short-term dexamethasone administration on glucose and insulin dynamics and muscle protein signaling in horses after the consumption of a high protein meal. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Loos
- University of Kentucky,Lexington, KY, United States
| | - S Dorsch
- University of Kentucky,Lexington, KY, United States
| | - A Gerritsen
- University of Kentucky,Lexington, KY, United States
| | - T Barnes
- University of Kentucky,Lexington, KY, United States
| | - K Urschel
- University of Kentucky,Lexington, KY, United States
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Mungroop TH, Gerritsen A, Duflou A, Busch OR, Mathus-Vliegen EM, Besselink MG. [Placement of nasoenteral feeding tubes by nurses]. Ned Tijdschr Geneeskd 2017; 160:D1104. [PMID: 28181898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Electromagnetic-guided placement of nasoenteral feeding tubes by nurses is an alternative to endoscopic placement by gastroenterologists. During placement, the electromagnetic signal that is emitted by the tip of the guidewire enables visualisation of the position of the tube on a portable monitor. The procedure can be performed by a trained endoscopy nurse at the bedside of the patient. This could have logistic advantages, as the patient transport is not necessary and confirmation of the position of the tube by an abdominal X-ray is not required. Other possible advantages of the new technique are no preprocedural fasting and no need for sedation. If the tube coils in the stomach, it can be repositioned without the need for a repeat procedure. A randomised multicentre trial found electromagnetic nasoenteral placement of feeding tubes to be non-inferior on comparison with endoscopic placement by gastroenterologists, and it can be considered as the preferred technique.
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Lamkaddem M, Essink-Bot ML, Devillé W, Gerritsen A, Stronks K. Health changes of refugees from Afghanistan, Iran and Somalia: the role of residence status and experienced living difficulties in the resettlement process. Eur J Public Health 2015; 25:917-22. [PMID: 25863280 DOI: 10.1093/eurpub/ckv061] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Worldwide, refugees show a poorer mental and physical health than the populations among which they resettle. Little is known about the factors influencing health after resettlement. We examined the development of mental and physical health of refugees. As experienced living difficulties might decrease with obtaining a residence permit, we expected this to play a central role in health improvement after resettlement. METHODS A two-wave study conducted in the Netherlands among a cohort of 172 recent (n = 68) and longstanding (n = 104) permit holders from Afghanistan, Iran and Somalia between 2003 and 2011. Multivariate mediation analyses were conducted for the effect of changes in living difficulties on the association between change in status and changes in health. Health outcomes were self-reported general health, number of chronic conditions, PTSD and anxiety/depression. RESULTS Recent permit holders had larger decreases in PTSD score (-0.402, CI -0.612; -0.192) and anxiety/depression score (-0.298, CI -0.464; -0.132), and larger improvements in self-rated general health between T1 and T2 (0.566, CI 0.183; 0.949) than longstanding permit holders. This association was not significant for changes in number of chronic conditions. Mediation analyses showed that the effect of getting a residence permit on health improvements transited through an improvement in living conditions, in particular employment and the presence of family/social support. CONCLUSION These results suggest that change in residence permit is beneficial for health mainly because of the change in living difficulties. These results add up to the evidence on the role of social circumstances for refugees upon resettlement, and point at labour participation and social support as key mechanisms for health improvements.
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Affiliation(s)
- Majda Lamkaddem
- 1 Department of Public Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Marie-Louise Essink-Bot
- 1 Department of Public Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Walter Devillé
- 2 NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands 3 Medical Anthropology and Sociology Unit, Faculty of Social and Behavioural Sciences, University of Amsterdam, The Netherlands 4 Pharos, Utrecht, The Netherlands
| | | | - Karien Stronks
- 1 Department of Public Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
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Gerritsen A, Bocquier P, White M, Mbacké C, Alam N, Beguy D, Odhiambo F, Sacoor C, Phuc HD, Punpuing S, Collinson MA. Health and demographic surveillance systems: contributing to an understanding of the dynamics in migration and health. Glob Health Action 2013; 6:21496. [PMID: 23849188 PMCID: PMC3710398 DOI: 10.3402/gha.v6i0.21496] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 06/19/2013] [Accepted: 06/19/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Migration is difficult to measure because it is highly repeatable. Health and Demographic Surveillance Systems (HDSSs) provide a unique opportunity to study migration as multiple episodes of migration are captured over time. A conceptual framework is needed to show the public health implications of migration. OBJECTIVE/DESIGN Research conducted in seven HDSS centres [International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network], published in a peer-reviewed volume in 2009, is summarised focussing on the age-sex profile of migrants, the relation between migration and livelihoods, and the impact of migration on health. This illustrates the conceptual structure of the implications of migration. The next phase is described, the Multi-centre Analysis of the Dynamics In Migration And Health (MADIMAH) project, consisting of workshops focussed on preparing data and conducting the analyses for comparative studies amongst HDSS centres in Africa and Asia. The focus here is on the (standardisation of) determinants of migration and the impact of migration on adult mortality. RESULTS The findings in the volume showed a relatively regular age structure for migration among all HDSS centres. Furthermore, migration generally contributes to improved living conditions at the place of origin. However, there are potential negative consequences of migration on health. It was concluded that there is a need to compare results from multiple centres using uniform covariate definitions as well as longitudinal analysis techniques. This was the starting point for the on-going MADIMAH initiative, which has increased capacity at the participating HDSS centres to produce the required datasets and conduct the analyses. CONCLUSIONS HDSS centres brought together within INDEPTH Network have already provided strong evidence of the potential negative consequences of migration on health, which contrast with the beneficial impacts of migration on livelihoods. Future comparative evidence using standardised tools will help design policies for mitigating the negative effects, and enhancing the positive effects, of migration on health.
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Affiliation(s)
- Annette Gerritsen
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Acornhoek, South Africa
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Gerritsen A, Molenaar IQ, Besselink MG. Authors' reply: systematic review of five feeding routes after pancreatoduodenectomy (Br J Surg 2013; 100: 589-598). Br J Surg 2013; 100:981. [PMID: 23640676 DOI: 10.1002/bjs.9151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Gerritsen A, Besselink MGH, Gouma DJ, Steenhagen E, Borel Rinkes IHM, Molenaar IQ. Systematic review of five feeding routes after pancreatoduodenectomy. Br J Surg 2013; 100:589-98; discussion 599. [PMID: 23354970 DOI: 10.1002/bjs.9049] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2012] [Indexed: 12/18/2022]
Abstract
BACKGROUND Current European guidelines recommend routine enteral feeding after pancreato-duodenectomy (PD), whereas American guidelines do not. The aim of this study was to determine the optimal feeding route after PD. METHODS A systematic search was performed in PubMed, Embase and the Cochrane Library. Included were studies on feeding routes after PD that reported length of hospital stay (primary outcome). RESULTS Of 442 articles screened, 15 studies with 3474 patients were included. Data on five feeding routes were extracted: oral diet (2210 patients), enteral nutrition via either a nasojejunal tube (NJT, 165), gastrojejunostomy tube (GJT, 52) or jejunostomy tube (JT, 623), and total parenteral nutrition (TPN, 424). Mean(s.d.) length of hospital stay was shortest in the oral diet and GJT groups (15(14) and 15(11) days respectively), followed by 19(12) days in the JT, 20(15) days in the TPN and 25(11) days in the NJT group. Normal oral intake was established most quickly in the oral diet group (mean 6(5) days), followed by 8(9) days in the NJT group. The incidence of delayed gastric emptying varied from 6 per cent (3 of 52 patients) in the GJT group to 23.2 per cent (43 of 185) in the JT group, but definitions varied widely. The overall morbidity rate ranged from 43.8 per cent (81 of 185) in the JT group to 75 per cent (24 of 32) in the GJT group. The overall mortality rate ranged from 1.8 per cent (3 of 165) in the NJT group to 5.4 per cent (23 of 424) in the TPN group. CONCLUSION There is no evidence to support routine enteral or parenteral feeding after PD. An oral diet may be considered as the preferred routine feeding strategy after PD.
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Affiliation(s)
- A Gerritsen
- Department of Surgery, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
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Loh KW, Vriens MR, Gerritsen A, Borel Rinkes IHM, van Hillegersberg R, Schippers C, Steenhagen E, Ong TA, Moy FM, Molenaar IQ. Unintentional weight loss is the most important indicator of malnutrition among surgical cancer patients. Neth J Med 2012; 70:365-369. [PMID: 23065984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Disease-related malnutrition is highly prevalent in hospital patients and varies from 25-40%. Early nutritional screening of patients at admission helps to improve recognition of malnourished patients to allow early interventions and enhance clinical outcomes. METHOD A total of 104 preoperative surgical patients with oesophageal (34), stomach (17) or pancreatic cancer (53) were recruited in our study. The risk of malnutrition was examined using the quick-and-easy Malnutrition Universal Screening Tool (MUST). Anthropometric data and information on percent weight change over the past six months, unintentional weight loss, dietician referrals, and history of nutritional intervention were collected. RESULTS A total of 75% of our participants were at high malnutrition risk with a mean (±SD) percentage weight loss of 5.18 (±6.23)%, despite a mean BMI of 26.09 (±5.73) kgm-2. Participants with a significantly higher percent weight loss, unintentional weight loss, dietician referral and nutritional intervention had a higher risk of malnutrition (p<0.05). Presence of unintentional weight loss was the only significant predictor (OR 3.22; 95%CI 1.23, 8.40) associated with risk of malnutrition after adjusted for all confounders. CONCLUSION In conclusion, our findings highlight the importance of routine screening of malnutrition in oncology patients. Medical personnel must be aware that unintentional weight loss is an important predictor of malnutrition risks even if the patient’s BMI is not suggestive of malnutrition.
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Affiliation(s)
- K W Loh
- Department of Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Kredo T, Gerritsen A, van Heerden J, Conway S, Siegfried N. Clinical practice guidelines within the Southern African Development Community: a descriptive study of the quality of guideline development and concordance with best evidence for five priority diseases. Health Res Policy Syst 2012; 10:1. [PMID: 22221856 PMCID: PMC3286374 DOI: 10.1186/1478-4505-10-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 01/05/2012] [Indexed: 11/28/2022] Open
Abstract
Background Reducing the burden of disease relies on availability of evidence-based clinical practice guidelines (CPGs). There is limited data on availability, quality and content of guidelines within the Southern African Development Community (SADC). This evaluation aims to address this gap in knowledge and provide recommendations for regional guideline development. Methods We prioritised five diseases: HIV in adults, malaria in children and adults, pre-eclampsia, diarrhoea in children and hypertension in primary care. A comprehensive electronic search to locate guidelines was conducted between June and October 2010 and augmented with email contact with SADC Ministries of Health. Independent reviewers used the AGREE II tool to score six quality domains reporting the guideline development process. Alignment of the evidence-base of the guidelines was evaluated by comparing their content with key recommendations from accepted reference guidelines, identified with a content expert, and percentage scores were calculated. Findings We identified 30 guidelines from 13 countries, publication dates ranging from 2003-2010. Overall the 'scope and purpose' and 'clarity and presentation' domains of the AGREE II instrument scored highest, median 58%(range 19-92) and 83%(range 17-100) respectively. 'Stakeholder involvement' followed with median 39%(range 6-75). 'Applicability', 'rigour of development' and 'editorial independence' scored poorly, all below 25%. Alignment with evidence was variable across member states, the lowest scores occurring in older guidelines or where the guideline being evaluated was part of broader primary healthcare CPG rather than a disease-specific guideline. Conclusion This review identified quality gaps and variable alignment with best evidence in available guidelines within SADC for five priority diseases. Future guideline development processes within SADC should better adhere to global reporting norms requiring broader consultation of stakeholders and transparency of process. A regional guideline support committee could harness local capacity to support context appropriate guideline development.
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Affiliation(s)
- Tamara Kredo
- South African Cochrane Centre, South African Medical Research Council, Cape Town, Western Cape, South Africa.
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Lutje V, Gerritsen A, Siegfried N. Randomized controlled trials of malaria intervention trials in Africa, 1948 to 2007: a descriptive analysis. Malar J 2011; 10:61. [PMID: 21406113 PMCID: PMC3064642 DOI: 10.1186/1475-2875-10-61] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 03/15/2011] [Indexed: 12/02/2022] Open
Abstract
Background Nine out of ten deaths from malaria occur in sub-Saharan Africa. Various control measures have achieved some progress in the control of the disease, but malaria is still a major public health problem in Africa. Randomized controlled trials (RCTs) are universally considered the best study type to rigorously assess whether an intervention is effective. The study reported here provides a descriptive analysis of RCTs reporting interventions for the prevention and treatment of malaria conducted in Africa, with the aim of providing detailed information on their main clinical and methodological characteristics, that could be used by researchers and policy makers to help plan future research. Methods Systematic searches for malaria RCTs were conducted using electronic databases (Medline, Embase, the Cochrane Library), and an African geographic search filter to identify RCTs conducted in Africa was applied. Results were exported to the statistical package STATA 8 to obtain a random sample from the overall data set. Final analysis of trial characteristics was done in a double blinded fashion by two authors using a standardized data extraction form. Results A random sample of 92 confirmed RCTs (from a total of 943 reports obtained between 1948 and 2007) was prepared. Most trials investigated drug treatment in children with uncomplicated malaria. Few trials reported on treatment of severe malaria or on interventions in pregnant women. Most trials were of medium size (100-500 participants), individually randomized and based in a single centre. Reporting of trial quality was variable. Although three-quarter of trials provided information on participants' informed consent and ethics approval, more details are needed. Conclusions The majority of malaria RCT conducted in Africa report on drug treatment and prevention in children; there is need for more research done in pregnant women. Sources of funding, informed consent and trial quality were often poorly reported. Overall, clearer reporting of trials is needed.
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Affiliation(s)
- Vittoria Lutje
- International Health Research Group, Liverpool School of Tropical Medicine, Liverpool, UK.
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Johnson AC, Aerni HR, Gerritsen A, Gibert M, Giger W, Hylland K, Jürgens M, Nakari T, Pickering A, Suter MJF, Svenson A, Wettstein FE. Comparing steroid estrogen, and nonylphenol content across a range of European sewage plants with different treatment and management practices. Water Res 2005; 39:47-58. [PMID: 15607163 DOI: 10.1016/j.watres.2004.07.025] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2003] [Revised: 04/08/2004] [Accepted: 07/16/2004] [Indexed: 05/24/2023]
Abstract
The effluent of 17 sewage treatment works (STW) across Norway, Sweden, Finland, The Netherlands, Belgium, Germany, France and Switzerland was studied for the presence of estradiol (E2), estrone (E1), ethinylestradiol (EE2) and nonylphenol (NP). Treatment processes included primary and chemical treatment only, submerged aerated filter, oxidation ditch, activated sludge (AS) and combined trickling filter with activated sludge. The effluent strength ranged between 87 and 846 L/PE (population equivalent), the total hydraulic retention time (HRT) ranged between 4 and 120 h, sludge retention time (SRT) between 3 and 30 d, and water temperature ranged from 12 to 21 degrees C. The highest estrogen values were detected in the effluent of the STW which only used primary treatment (13 ng/L E2 and 35 ng/L E1) and on one occasion in one of the STW using the AS system (6.5 ng/L E2, 50.5 ng/L E1, but on three other occasions the concentrations in this STW were at least a factor of 6 lower). For the 16 STW employing secondary treatment E2 was only detected in the effluent of six works during the study period (average 0.7-5.7 ng/L). E1 was detected in the effluent of 13 of the same STW. The median value for E1 for the 16 STW with secondary treatment was 3.0 ng/L. EE2 was only detected in two STW (1.1, <0.8-2.8 ng/L). NP could be detected in the effluent of all 14 STW where this measurement was attempted, with a median of 0.31 microg/L and values ranging from 0.05 to 1.31 microg/L. A comparison of removal performance for E1 was carried out following prediction of the probable influent concentration. A weak but significant (alpha<5%) correlation between E1 removal and HRT or SRT was observed.
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Affiliation(s)
- A C Johnson
- CEH Wallingford, Maclean Building, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK.
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Gerritsen A, van der Hoeven N, Pielaat A. The acute toxicity of selected alkylphenols to young and adult Daphnia magna. Ecotoxicol Environ Saf 1998; 39:227-232. [PMID: 9570914 DOI: 10.1006/eesa.1997.1578] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Differences in sensitivity toward toxicants between young and adult individuals in a population are assumed to be primarily associated with their difference in body size. This assumption plays a key role in the modeling of effects of variable concentrations of toxicants on nonhomogeneous populations. The hazard-based no-effect-concentrations (NECs), killing rates, and elimination rates, estimated from the survival data of a series of acute toxicity tests with young and adults of Daphnia magna and six alkylphenols, were used to evaluated this assumption. The results lead to the conclusion that young and adult D. magna were equally sensitive in terms of NEC and killing rate and that the observed differences in elimination rates could be explained on the basis of a difference in body size. Furthermore, it was found that elimination rates estimated on the basis of the survival data were consistently smaller than those expected on the basis of a QSAR for Daphnia pulex, a comparable species. This discrepancy was likely due to a decreased uptake and elimination during a period of immobilization prior to death. Since it is unknown to what extent immobilized individuals are able to recover from short-term exposures, the observed deviation clearly identifies a complicating factor in the modeling of effects of variable concentrations of toxicants.
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Affiliation(s)
- A Gerritsen
- Department of Environmental Toxicology, TNO-Toxicology, Delft, The Netherlands
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Gerritsen A. Expression of the interleukin-2 receptor on human renal proximal tubular epithelial cells. Immunol Lett 1997. [DOI: 10.1016/s0165-2478(97)87986-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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de Haan P, Heemskerk AE, Gerritsen A, de Boer EM, Sampat S, van der Raaij-Helmer EM, Bruynzeel DP. Comparison of toxicity tests on human skin and epidermoid (A431) cells using free fatty acids as test substances. Clin Exp Dermatol 1993; 18:428-33. [PMID: 8252764 DOI: 10.1111/j.1365-2230.1993.tb02243.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Several in-vivo methods can be used to determine the ability of chemical compounds to induce skin irritancy. In this study we estimated in vivo the capacity of several free fatty acids to induce skin irritancy and compared the results with those found in in vitro tests. Skin irritancy induced by free fatty acids (chain lengths: C6, C7, C9, C10, C11, C13 and C18) was evaluated in humans by means of laser-Doppler flowmetry (LDF) and visual scoring (VS). Both methods demonstrated that the toxic effect of free fatty acids determined by LDF and VS increased from C6 through C11 and decreased again for C13 and C18. The cytotoxic effect of these free fatty acids on cells was measured in vitro by incubation of human epidermoid cells (A431) with these compounds. It was determined by measuring: (a) the number of dead cells by inclusion of Trypan blue (TB); and (b) the number of living cells by mitochondrial metabolism of 3-[4,5-dimethylthiazole-2-yl]-2,5 diphenyltetrazolium bromide (MTT). The LD-50 concentrations decreased from C6 through C11 in both in-vitro assays. The results of the in-vitro assays for C13 and C18 both demonstrated a discrepancy. The cytotoxic effect of the free fatty acids expressed as LD-50 values, determined after 20 min with the TB assay, was seen at higher concentrations than after incubation for 18 h (MTT assay). From the results it was concluded that C13 in particular affected skin blood flow. We also determined correlation coefficients between the in-vivo and in-vitro methods. When C13 is excluded these coefficients ranged from -0.77 to -0.92.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P de Haan
- Department of Dermatology, Academic Hospital Free University, Amsterdam, The Netherlands
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Hendrich K, Gerritsen A. [Training first-grade instructors in nursing. A new course]. TVZ 1991:783-4. [PMID: 1751001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Peters RC, Loos WJG, Gerritsen A. Distribution of electroreceptors, bioelectric field patterns, and skin resistance in the catfish,Ictalurus nebulosus LeS. J Comp Physiol A Neuroethol Sens Neural Behav Physiol 1974. [DOI: 10.1007/bf00696523] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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