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Bouwman K, Moazzen S, Kroah-Hartman M, Dijkstra G, Horváth B, Alizadeh BZ. Diet and physical activity as risk-reducing factors for hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2024; 38:910-919. [PMID: 38116943 DOI: 10.1111/jdv.19726] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a multifactorial inflammatory skin disease that is considered to be an immune-mediated inflammatory disease (IMID). Up till now, the impact of lifestyle on (the development of) HS has not been thoroughly investigated. OBJECTIVES To investigate the effect of dietary intake and physical activity (PA) on (the development of) HS. MATERIALS AND METHODS A nested case-control study was performed within the longitudinal Lifelines Cohort Study, that took place in the Northern Netherlands, and identified 1004 adult eligible HS patients and 5000 age-matched controls. Dietary data were collected using a validated food frequency questionnaire, subsequently translated to the Lifelines Diet Score (LLDS), alternate Mediterranean Diet Score (aMED) and Dutch Dietary Guidelines score (DDG), with higher scores reflecting healthier dietary habits. PA was measured by the Short Questionnaire to Assess Health-enhancing PA score. Logistic regression analyses were performed between dietary/PA scores, and the prevalence/development and severity of HS. RESULTS Compared to controls, HS patients scored lower on the LLDS [OR = 0.98; 95% CI 0.96-0.99], aMED [0.93; 0.89-0.97] and DDG [0.93; 0.88-0.97] with multivariable regression analysis. Overall, this indicates less adherence to dietary recommendations and consumption of a low-quality diet in the HS population. Lower adherence to the LLDS and DDG was also significantly associated with a higher likelihood to HS development in univariable regression analysis [0.96; 0.94-0.99 and 0.91; 0.84-0.99, respectively], and a trend of decreased adherence to the aMED [0.93; 0.85-1.02] was noted. Besides, PA levels were found significantly lower in HS patients (p ≤ 0.001). CONCLUSIONS AND RELEVANCE Poor diet quality and lower quantities of PA were associated with HS in the general population. Identifying dietary and PA habits of HS patients can contribute to the development of prevention strategies for HS specifically, and for IMIDs in general.
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Affiliation(s)
- Klasiena Bouwman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sara Moazzen
- Molecular Epidemiology Research Group, MDC Berlin-Buch, Max-Delbrück-Center for Molecular Medicine in der Helmholtz-Gemeinschaft, Berlin, Germany
| | - Madeline Kroah-Hartman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerard Dijkstra
- Department of Gastroenterology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara Horváth
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Behrooz Ziad Alizadeh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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2
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Van Rest KLC, Gielen MJCAM, Warmerdam LM, Kowalik CR, Roovers JPWR, Zwaans WAR. Prediction of successful revision surgery for mesh-related complaints after inguinal hernia and pelvic organ prolapse repair. Hernia 2024; 28:401-410. [PMID: 36753034 PMCID: PMC10997688 DOI: 10.1007/s10029-023-02748-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/22/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE With this retrospective case series, we aim to identify predictors for reduction of pain after mesh revision surgery in patients operated for inguinal hernia or pelvic organ prolapse with a polypropylene implant. Identifying these predictors may aid surgeons to counsel patients and select appropriate candidates for mesh revision surgery. METHODS Clinical records before and after mesh revision surgery from 221 patients with chronic postoperative inguinal pain (CPIP) and 59 patients with pain after pelvic organ prolapse (POP) surgery were collected at two experienced tertiary referral centers. Primary outcome was patient reported improvement of pain after revision surgery. A multivariable logistic regression model was used to specify predictors for pain reduction. RESULTS The multivariable logistic regression was performed for each patient group separately. Patients with CPIP had higher chances of improvement of pain when time between mesh placement and mesh revision surgery was longer, with an OR of 1.19 per year. A turning point in chances of risks and benefits was demonstrated at 70 months, with improved outcomes for patients with revision surgery ≥ 70 months (OR 2.86). For POP patients, no statistically significant predictors for reduction of pain after (partial) removal surgery could be identified. CONCLUSION A longer duration of at least 70 months between implantation of inguinal mesh and revision surgery seems to give a higher chance on improvement of pain. Caregivers should not avoid surgery based on a longer duration of symptoms when an association between symptoms and the location of the mesh is found.
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Affiliation(s)
- K L C Van Rest
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
| | - M J C A M Gielen
- Department of Surgery, Máxima Medical Center, Veldhoven/Eindhoven, The Netherlands
| | | | - C R Kowalik
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Bergman Clinics Vrouw, Amsterdam, The Netherlands
- Research Consortium Mesh, Utrecht, The Netherlands
| | - J P W R Roovers
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Bergman Clinics Vrouw, Amsterdam, The Netherlands
- Research Consortium Mesh, Utrecht, The Netherlands
| | - W A R Zwaans
- Department of Surgery, Máxima Medical Center, Veldhoven/Eindhoven, The Netherlands
- Research Consortium Mesh, Utrecht, The Netherlands
- SolviMáx, Center of Excellence for Abdominal Wall and Groin Pain, Eindhoven, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht UMC+, Maastricht, The Netherlands
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van Hagen CCE, Huiberts AJ, Mutubuki EN, de Melker HE, Vos ERA, van de Wijgert JHHM, van den Hof S, Knol MJ, van Hoek AJ. Health-related quality of life during the COVID-19 pandemic: The impact of restrictive measures using data from two Dutch population-based cohort studies. PLoS One 2024; 19:e0300324. [PMID: 38498510 PMCID: PMC10947685 DOI: 10.1371/journal.pone.0300324] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/23/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVES We describe health-related quality of life during the COVID-19 pandemic in the general Dutch population and correlations with restrictive measures. METHODS Data were obtained from 18-85 year-old participants of two population-based cohort studies (February 2021-July 2022): PIENTER Corona (n = 8,019) and VASCO (n = 45,413). Per cohort, mean scores of mental and physical health and health utility from the SF-12 were calculated by age group, sex and presence of a medical risk condition. Spearman correlations with stringency of measures were calculated. RESULTS Both cohorts showed comparable results. Participants <30 years had lowest health utility and mental health score, and highest physical health score. Health utility and mental health score increased with age (up to 79 years), while physical health score decreased with age. Women and participants with a medical risk condition scored lower than their counterparts. Fluctuations were small over time but most pronounced among participants <60 years, and correlated weakly, but mostly positively with measure stringency. CONCLUSIONS During the Dutch COVID-19 epidemic, health utility and mental health scores were lower and fluctuated strongest among young adults compared to older adults. In our study population, age, sex and presence of a medical risk condition seemed to have more impact on health scores than stringency of COVID-19 non-pharmaceutical interventions.
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Affiliation(s)
- Cheyenne C. E. van Hagen
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Anne J. Huiberts
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Elizabeth N. Mutubuki
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E. de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Eric R. A. Vos
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Janneke H. H. M. van de Wijgert
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J. Knol
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Albert Jan van Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
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4
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Trindade Pons V, Claringbould A, Kamphuis P, Oldehinkel AJ, van Loo HM. Using parent-offspring pairs and trios to estimate indirect genetic effects in education. Genet Epidemiol 2024. [PMID: 38472165 DOI: 10.1002/gepi.22554] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 02/06/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024]
Abstract
We investigated indirect genetic effects (IGEs), also known as genetic nurture, in education with a novel approach that uses phased data to include parent-offspring pairs in the transmitted/nontransmitted study design. This method increases the power to detect IGEs, enhances the generalizability of the findings, and allows for the study of effects by parent-of-origin. We validated and applied this method in a family-based subsample of adolescents and adults from the Lifelines Cohort Study in the Netherlands (N = 6147), using the latest genome-wide association study data on educational attainment to construct polygenic scores (PGS). Our results indicated that IGEs play a role in education outcomes in the Netherlands: we found significant associations of the nontransmitted PGS with secondary school level in youth between 13 and 24 years old as well as with education attainment and years of education in adults over 25 years old (β = 0.14, 0.17 and 0.26, respectively), with tentative evidence for larger maternal IGEs. In conclusion, we replicated previous findings and showed that including parent-offspring pairs in addition to trios in the transmitted/nontransmitted design can benefit future studies of parental IGEs in a wide range of outcomes.
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Affiliation(s)
- Victória Trindade Pons
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Annique Claringbould
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Structural & Computational Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Priscilla Kamphuis
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Albertine J Oldehinkel
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hanna M van Loo
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Schalkwijk H, Felder M, Lalleman P, Parry MS, Schoonhoven L, Wallenburg I. Five pathways into one profession: Fifty years of debate on differentiated nursing practice. Nurs Inq 2024:e12631. [PMID: 38470567 DOI: 10.1111/nin.12631] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
The persistence of multiple educational pathways into the nursing profession continues to occupy scholars internationally. In the Netherlands, various groups within the Dutch healthcare sector have tried to differentiate nursing practice on the basis of educational backgrounds for over 50 years. Proponents argue that such reforms are needed to retain bachelor-trained nurses, improve quality of care and strengthen nurses' position in the sector. Opponents have actively resisted reforms because they would mainly benefit bachelor-trained nurses and neglect practical experience and technical skills. This historical case study aims to provide insight in this apparent stalemate. Our analysis of this debate is informed by literature on institutional work and current debates within the historiography of nursing. This study contributes to a better understanding of this contemporary debate by examining a broader timeframe than is usually studied, and by highlighting nurses' roles in complex processes of change. We argue that, rather than being stuck in their professional development, different groups of nurses have forged their own path forward in their professional development, albeit via different strategies.
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Affiliation(s)
- Hugo Schalkwijk
- Research Group of Person-Centredness in an Ageing Society, Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Department of History, University of Amsterdam, Amsterdam, The Netherlands
| | - Martijn Felder
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
| | - Pieterbas Lalleman
- Research Group of Person-Centredness in an Ageing Society, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Manon S Parry
- Department of History, University of Amsterdam, Amsterdam, The Netherlands
- Department of Art & Culture, History and Antiquity, VU, Amsterdam, The Netherlands
| | - Lisette Schoonhoven
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Iris Wallenburg
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
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Riesmeijer SA, Nolte IM, Olde Loohuis LM, Reus LM, Boltz T, Ng M, Furniss D, Werker PMN, Ophoff RA. Polygenic Risk Associations with Clinical Characteristics and Recurrence of Dupuytren Disease. Plast Reconstr Surg 2024; 153:573e-583e. [PMID: 37257093 PMCID: PMC10876167 DOI: 10.1097/prs.0000000000010775] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/22/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Dupuytren disease (DD) is a common complex trait, with varying severity and incompletely understood cause. Genome-wide association studies (GWAS) have identified risk loci. In this article, we examine whether genetic risk profiles of DD in patients are associated with clinical variation and disease severity and with patient genetic risk profiles of genetically correlated traits, including body mass index (BMI), triglycerides, high-density lipoproteins, type 2 diabetes mellitus, and endophenotypes fasting glucose and glycated hemoglobin. METHODS The authors used a well-characterized cohort of 1461 DD patients with available phenotypic and genetic data. Phenotype data include age at onset, recurrence, and family history of disease. Polygenic risk scores (PRSs) of DD, BMI, triglycerides, high-density lipoprotein, type 2 diabetes, fasting glucose, and hemoglobin A1c using various significance thresholds were calculated with PRSice using the most recent GWAS summary statistics. Control data from LifeLines were used to determine P value cutoffs for PRS generation explaining most variance. RESULTS The PRS for DD was significantly associated with a positive family history for DD, age at onset, disease onset before the age of 50, and recurrence. We also found a significant negative correlation between the PRSs for DD and BMI. CONCLUSIONS Although GWAS studies of DD are designed to identify genetic risk factors distinguishing case/control status, we show that the genetic risk profile for DD also explains part of its clinical variation and disease severity. The PRS may therefore aid in accurate prognostication, choosing initial treatment and in personalized medicine in the future. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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Affiliation(s)
- Sophie A. Riesmeijer
- From the Departments of Plastic Surgery
- Epidemiology, University of Groningen, University Medical Center Groningen
| | - Ilja M. Nolte
- Epidemiology, University of Groningen, University Medical Center Groningen
| | - Loes M. Olde Loohuis
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Lianne M. Reus
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center
| | - Toni Boltz
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Michael Ng
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford
| | - Dominic Furniss
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford
| | | | - Roel A. Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
- Department of Psychiatry, Erasmus University Rotterdam, Erasmus Medical Center
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7
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Zachreson C, Savulescu J, Shearer FM, Plank MJ, Coghlan S, Miller JC, Ainslie KEC, Geard N. Ethical frameworks should be applied to computational modelling of infectious disease interventions. PLoS Comput Biol 2024; 20:e1011933. [PMID: 38512898 PMCID: PMC10956870 DOI: 10.1371/journal.pcbi.1011933] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
This perspective is part of an international effort to improve epidemiological models with the goal of reducing the unintended consequences of infectious disease interventions. The scenarios in which models are applied often involve difficult trade-offs that are well recognised in public health ethics. Unless these trade-offs are explicitly accounted for, models risk overlooking contested ethical choices and values, leading to an increased risk of unintended consequences. We argue that such risks could be reduced if modellers were more aware of ethical frameworks and had the capacity to explicitly account for the relevant values in their models. We propose that public health ethics can provide a conceptual foundation for developing this capacity. After reviewing relevant concepts in public health and clinical ethics, we discuss examples from the COVID-19 pandemic to illustrate the current separation between public health ethics and infectious disease modelling. We conclude by describing practical steps to build the capacity for ethically aware modelling. Developing this capacity constitutes a critical step towards ethical practice in computational modelling of public health interventions, which will require collaboration with experts on public health ethics, decision support, behavioural interventions, and social determinants of health, as well as direct consultation with communities and policy makers.
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Affiliation(s)
- Cameron Zachreson
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
| | - Julian Savulescu
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Biomedical Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- Faculty of Philosophy, University of Oxford, Oxford, United Kingdom
| | - Freya M. Shearer
- Infectious Disease Dynamics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael J. Plank
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
| | - Simon Coghlan
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
- Centre for AI and Digital Ethics, The University of Melbourne, Parkville, Victoria, Australia
| | - Joel C. Miller
- Department of Mathematical and Physical Sciences, La Trobe University, Bundoora, Australia
| | - Kylie E. C. Ainslie
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Nicholas Geard
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
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Cevirgel A, Vos M, Holtrop AF, Beckers L, Reukers DFM, Meijer A, Rots N, van Beek J, van Baarle D, de Wit J. Delineating immune variation between adult and children COVID-19 cases and associations with disease severity. Sci Rep 2024; 14:5090. [PMID: 38429462 PMCID: PMC10907598 DOI: 10.1038/s41598-024-55148-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024] Open
Abstract
The SARS-CoV-2 pandemic has emphasized the need to explore how variations in the immune system relate to the severity of the disease. This study aimed to explore inter-individual variation in response to SARS-CoV-2 infection by comparing T cell, B cell, and innate cell immune subsets among primary infected children and adults (i.e., those who had never experienced SARS-CoV-2 infection nor received vaccination previously), with varying disease severity after infection. We also examined immune subset kinetics in convalescent individuals compared to those with persistent infection to identify possible markers of immune dysfunction. Distinct immune subset differences were observed between infected adults and children, as well as among adult cases with mild, moderate, and severe disease. IgM memory B cells were absent in moderate and severe cases whereas frequencies of B cells with a lack of surface immunoglobulin expression were significantly higher in severe cases. Interestingly, these immune subsets remained stable during recovery implying that these subsets could be associated with underlying baseline immune variation. Our results offer insights into the potential immune markers associated with severe COVID-19 and provide a foundation for future research in this area.
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Affiliation(s)
- Alper Cevirgel
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Martijn Vos
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Anne Floor Holtrop
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lisa Beckers
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Daphne F M Reukers
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Adam Meijer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Nynke Rots
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Josine van Beek
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Debbie van Baarle
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Medical Microbiology and Infection Prevention, Virology and Immunology Research Group, University Medical Center Groningen, Groningen, The Netherlands
| | - Jelle de Wit
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
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9
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De Koster S, Xavier BB, Lammens C, Perales Selva N, van Kleef-van Koeveringe S, Coenen S, Glupczynski Y, Leroux-Roels I, Dhaeze W, Hoebe CJPA, Dewulf J, Stegeman A, Kluytmans-Van den Bergh M, Kluytmans J, Goossens H. One Health surveillance of colistin-resistant Enterobacterales in Belgium and the Netherlands between 2017 and 2019. PLoS One 2024; 19:e0298096. [PMID: 38394276 PMCID: PMC10890735 DOI: 10.1371/journal.pone.0298096] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/17/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Colistin serves as the last line of defense against multidrug resistant Gram-negative bacterial infections in both human and veterinary medicine. This study aimed to investigate the occurrence and spread of colistin-resistant Enterobacterales (ColR-E) using a One Health approach in Belgium and in the Netherlands. METHODS In a transnational research project, a total of 998 hospitalized patients, 1430 long-term care facility (LTCF) residents, 947 children attending day care centres, 1597 pigs and 1691 broilers were sampled for the presence of ColR-E in 2017 and 2018, followed by a second round twelve months later for hospitalized patients and animals. Colistin treatment incidence in livestock farms was used to determine the association between colistin use and resistance. Selective cultures and colistin minimum inhibitory concentrations (MIC) were employed to identify ColR-E. A combination of short-read and long-read sequencing was utilized to investigate the molecular characteristics of 562 colistin-resistant isolates. Core genome multi-locus sequence typing (cgMLST) was applied to examine potential transmission events. RESULTS The presence of ColR-E was observed in all One Health sectors. In Dutch hospitalized patients, ColR-E proportions (11.3 and 11.8% in both measurements) were higher than in Belgian patients (4.4 and 7.9% in both measurements), while the occurrence of ColR-E in Belgian LTCF residents (10.2%) and children in day care centres (17.6%) was higher than in their Dutch counterparts (5.6% and 12.8%, respectively). Colistin use in pig farms was associated with the occurrence of colistin resistance. The percentage of pigs carrying ColR-E was 21.8 and 23.3% in Belgium and 14.6% and 8.9% in the Netherlands during both measurements. The proportion of broilers carrying ColR-E in the Netherlands (5.3 and 1.5%) was higher compared to Belgium (1.5 and 0.7%) in both measurements. mcr-harboring E. coli were detected in 17.4% (31/178) of the screened pigs from 7 Belgian pig farms. Concurrently, four human-related Enterobacter spp. isolates harbored mcr-9.1 and mcr-10 genes. The majority of colistin-resistant isolates (419/473, 88.6% E. coli; 126/166, 75.9% Klebsiella spp.; 50/75, 66.7% Enterobacter spp.) were susceptible to the critically important antibiotics (extended-spectrum cephalosporins, fluoroquinolones, carbapenems and aminoglycosides). Chromosomal colistin resistance mutations have been identified in globally prevalent high-risk clonal lineages, including E. coli ST131 (n = 17) and ST1193 (n = 4). Clonally related isolates were detected in different patients, healthy individuals and livestock animals of the same site suggesting local transmission. Clonal clustering of E. coli ST10 and K. pneumoniae ST45 was identified in different sites from both countries suggesting that these clones have the potential to spread colistin resistance through the human population or were acquired by exposure to a common (food) source. In pig farms, the continuous circulation of related isolates was observed over time. Inter-host transmission between humans and livestock animals was not detected. CONCLUSIONS The findings of this study contribute to a broader understanding of ColR-E prevalence and the possible pathways of transmission, offering insights valuable to both academic research and public health policy development.
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Affiliation(s)
- Sien De Koster
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Basil Britto Xavier
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- Department of Clinical Sciences, Institute of Tropical Medicine, HIV/STI Unit, Antwerp, Belgium
- Hospital Outbreak Support Team-HOST, ZNA Middelheim, Antwerp, Belgium
- Hospital Outbreak Support Team-HOST, GZA Ziekenhuizen, Wilrijk, Belgium
| | - Christine Lammens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | | | | | - Samuel Coenen
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Youri Glupczynski
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Isabel Leroux-Roels
- Laboratory of Medical Microbiology and Infection Control Department, Ghent University Hospital, Ghent, Belgium
| | | | - Christian J. P. A. Hoebe
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Maastricht University Medical Center+, Maastricht, The Netherlands
- Living Lab Public Health, Public Health Service South Limburg, Heerlen, the Netherlands
| | - Jeroen Dewulf
- Faculty of Veterinary Medicine, Department of Internal Medicine, Reproduction and Population Medicine, Veterinary Epidemiology Unit, Ghent University, Merelbeke, Belgium
| | - Arjan Stegeman
- Faculty of Veterinary Medicine, Department of Population Health Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marjolein Kluytmans-Van den Bergh
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands
- Amphia Academy Infectious Disease Foundation, Amphia Hospital, Breda, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jan Kluytmans
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Microvida Laboratory for Microbiology, Amphia Hospital, Breda, The Netherlands
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Dankers PW, Janssen SHM, van Eenbergen M, Siflinger BM, van der Graaf WTA, Husson O. Employment outcomes of adolescent and young adult (AYA) cancer survivors and their partners: A Dutch population-based study. Cancer 2024. [PMID: 38396253 DOI: 10.1002/cncr.35260] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The aim of this population-based registry study was to examine the impact of cancer on employment outcomes in adolescent and young adult (AYA) survivors and their partners and associated sociodemographic and clinical characteristics. METHODS A total of 2456 AYA cancer patients, diagnosed in 2013 and aged 18 through 39 years old, were selected from the Netherlands Cancer Registry and linked to employment data from Statistics Netherlands, from which 1252 partners of AYAs could be identified. For both patients and their partners, a control group with same age, migration background, and sex was selected. The impact (i.e., causal effect) was estimated by implementing a doubly robust difference-in-differences method, from 3 years before to 5 years after cancer diagnosis. RESULTS Patients suffered a reduced employment probability (3.8 percentage points) and number of hours worked when employed (3.8%). This effect was larger for females, and individuals with a migration background, high tumor stage, or diagnosed with a central nervous system tumor/hematologic malignancy. In regard to employment, no significant effect could be found for the patients' partners, although a 5.5 percentage-point increase in employment probability was found in partners who were either unemployed or worked fewer than 400 hours. CONCLUSIONS A cancer diagnosis significantly affects employment outcomes of AYA patients with cancer. Patients at risk should have access to services such as job counseling to help them return into society in the best possible way. No objective impact on partners' employment outcomes was found; however, subjective well-being was not taken into account. PLAIN LANGUAGE SUMMARY This study estimated the causal effect of a cancer diagnosis on employment outcomes. Adolescent and young adult cancer survivors face a reduction in both employment probability and the number of hours worked when employed. Partners that were unemployed or worked the least number of hours a year before diagnosis had a 5.5 percentage-point increased employment probability, but for other partners effects are small.
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Affiliation(s)
- Polle W Dankers
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Econometrics and Operations Research, Tilburg University, Tilburg, The Netherlands
| | - Silvie H M Janssen
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Mies van Eenbergen
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
| | - Bettina M Siflinger
- Department of Econometrics and Operations Research, Tilburg University, Tilburg, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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11
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de Boer PT, van Werkhoven CH, van Hoek AJ, Knol MJ, Sanders EAM, Wallinga J, de Melker HE, Steens A. Higher-valency pneumococcal conjugate vaccines in older adults, taking into account indirect effects from childhood vaccination: a cost-effectiveness study for the Netherlands. BMC Med 2024; 22:69. [PMID: 38360645 PMCID: PMC10870576 DOI: 10.1186/s12916-024-03277-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND New 15- and 20-valent pneumococcal vaccines (PCV15, PCV20) are available for both children and adults, while PCV21 for adults is in development. However, their cost-effectiveness for older adults, taking into account indirect protection and serotype replacement from a switch to PCV15 and PCV20 in childhood vaccination, remains unexamined. METHODS We used a static model for the Netherlands to assess the cost-effectiveness of different strategies with 23-valent pneumococcal polysaccharide vaccine (PPV23), PCV15, PCV20, and PCV21 for a 65-year-old cohort from a societal perspective, over a 15-year time horizon. Childhood vaccination was varied from PCV10 to PCV13, PCV15, and PCV20. Indirect protection was assumed to reduce the incidence of vaccine serotypes in older adults by 80% (except for serotype 3, no effect), completely offset by an increase in non-vaccine serotype incidence due to serotype replacement. RESULTS Indirect effects from childhood vaccination reduced the cost-effectiveness of vaccination of older adults, depending on the serotype overlap between the vaccines. With PCV10, PCV13, or PCV15 in children, PCV20 was more effective and less costly for older adults than PPV23 and PCV15. PCV20 costs approximately €10,000 per quality-adjusted life year (QALY) gained compared to no pneumococcal vaccination, which falls below the conventional Dutch €20,000/QALY gained threshold. However, with PCV20 in children, PCV20 was no longer considered cost-effective for older adults, costing €22,550/QALY gained. As indirect effects progressed over time, the cost-effectiveness of PCV20 for older adults further diminished for newly vaccinated cohorts. PPV23 was more cost-effective than PCV20 for cohorts vaccinated 3 years after the switch to PCV20 in children. PCV21 offered the most QALY gains, and its cost-effectiveness was minimally affected by indirect effects due to its coverage of 11 different serotypes compared to PCV20. CONCLUSIONS For long-term cost-effectiveness in the Netherlands, the pneumococcal vaccine for older adults should either include invasive serotypes not covered by childhood vaccination or become more affordable than its current pricing for individual use.
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Affiliation(s)
- Pieter T de Boer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Cornelis H van Werkhoven
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Albert Jan van Hoek
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Elisabeth A M Sanders
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jacco Wallinga
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Biomedical Datasciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Anneke Steens
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Gorgels KM, van Iersel SC, Keijser SF, Hoebe CJ, Wallinga J, van Hoek AJ. Estimating infection prevalence using the positive predictive value of self-administered rapid antigen diagnostic tests: An exploration of SARS-CoV-2 surveillance data in the Netherlands from May 2021 to April 2022. PLoS One 2024; 19:e0298218. [PMID: 38349925 PMCID: PMC10863887 DOI: 10.1371/journal.pone.0298218] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
Measuring the severity of the disease of SARS-CoV-2 is complicated by the lack of valid estimations for the prevalence of infection. Self-administered rapid antigen diagnostic tests (Ag-RDTs) were available in the Netherlands since March 2021, requiring confirmation by reverse-transcription polymerase chain reaction (RT-PCR) for positive results. We explored the possibility of utilizing the positive predictive value (PPV) of Ag-RDTs to estimate SARS-CoV-2 prevalence. We used data from all Public Health service testing facilities between 3 May 2021 and 10 April 2022. The PPV was calculated by dividing the number of positive RT-PCR results by the total number of confirmation tests performed, and used to estimate the prevalence and compared with the number of COVID-19 hospital admissions. In total 3,599,894 cases were included. The overall PPV was 91.8% and 88.8% were symptomatic. During our study period, the estimated prevalence ranged between 2-22% in symptomatic individuals and 2-14% in asymptomatic individuals, with a correlation between the estimated prevalence and hospital admissions two weeks later (r = 0.68 (p<0.01) and r = 0.60 (p<0.01) for symptomatic/asymptomatic individuals). The PPV of Ag-RDTs can help estimate changes in SARS-CoV-2 prevalence, especially when used in conjunction with other surveillance systems. However, the used method probably overestimated the true prevalence because of unmonitored differences in test propensity between individuals.
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Affiliation(s)
- Koen M.F. Gorgels
- Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Senna C.J.L. van Iersel
- Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Sylvia F.A. Keijser
- Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Christian J.P.A. Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Jacco Wallinga
- Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Albert J. van Hoek
- Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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13
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Heine RJSD, Thielen FW, Mathijssen RHJ, van Leeuwen RWF, Franken MG, Uyl-de Groot CA. Applying a cost-based pricing model for innovative cancer treatments subject to indication expansion: A case study for pembrolizumab and daratumumab. PLoS One 2024; 19:e0293264. [PMID: 38300937 PMCID: PMC10833582 DOI: 10.1371/journal.pone.0293264] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/09/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Expanding the indication of already approved immuno-oncology drugs presents treatment opportunities for patients but also strains healthcare systems. Cost-based pricing models are discussed as a possibility for cost containment. This study focuses on two drugs, pembrolizumab (Keytruda) and daratumumab (Darzalex), to explore the potential effect of indication broadening on the estimated price when using the cost-based pricing (CBP) model proposed by Uyl-de Groot and Löwenberg (2018). METHODS The model was used to calculate cumulative yearly prices, cumulative prices per indication, and non-cumulative indication-based prices using inputs such as research and development (R&D) costs, manufacturing costs, eligible patient population, and a profit margin. A deterministic stepwise analysis and scenario analysis were conducted to examine how sensitive the estimated price is to the different input assumptions. RESULTS The yearly cumulative cost-based prices (CBPs) ranged from €52 to €885 for pembrolizumab per vial and €823 to €31,941 for daratumumab per vial. Prices were higher in initial years or indications due to smaller patient populations, decreased over time or after additional indications. Sensitivity analysis showed that the number of eligible patients had the most significant impact on the estimated price. In the scenario analysis the profit margin contributed most to a higher CBPs for both drugs. Lower estimates resulted from assumed lower R&D costs. DISCUSSION The estimated CBPs are consistently lower than Dutch list prices for pembrolizumab (€2,861), mainly resulting from larger patient populations in registered indications. However, daratumumab's list prices fall within the range of modeled CBPs depending on the year or indication (€4,766). Both CBPs decrease over time or with additional indications. The number of eligible patients and initial R&D costs have the most significant influence on the CBPs. These findings contribute to the ongoing discussions on pharmaceutical pricing, especially concerning cancer drugs with expanding indications.
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Affiliation(s)
- R. J. S. D. Heine
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - F. W. Thielen
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - R. H. J. Mathijssen
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, Rotterdam, The Netherlands
| | - R. W. F. van Leeuwen
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, Rotterdam, The Netherlands
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, Rotterdam, The Netherlands
| | - M. G. Franken
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - C. A. Uyl-de Groot
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
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14
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Aguilera Saiz L, Groen HC, Heerink WJ, Ruers TJM. The influence of the da Vinci surgical robot on electromagnetic tracking in a clinical environment. J Robot Surg 2024; 18:54. [PMID: 38280064 PMCID: PMC10821979 DOI: 10.1007/s11701-023-01812-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/23/2023] [Indexed: 01/29/2024]
Abstract
Robot-assisted surgery is increasingly used in surgery for cancer. Reduced overview and loss of anatomical orientation are challenges that might be solved with image-guided surgical navigation using electromagnetic tracking (EMT). However, the robot's presence may distort the electromagnetic field, affecting EMT accuracy. The aim of this study was to evaluate the robot's influence on EMT accuracy. For this purpose, two different electromagnetic field generators were used inside a clinical surgical environment: a table top field generator (TTFG) and a planar field generator (PFG). The position and orientation of sensors within the electromagnetic field were measured using an accurate in-house developed 3D board. Baseline accuracy was measured without the robot, followed by stepwise introduction of potential distortion sources (robot and robotic instruments). The absolute accuracy was determined within the entire 3D board and in the clinical working volume. For the baseline setup, median errors in the entire tracking volume within the 3D board were 0.9 mm and 0.3° (TTFG), and 1.1 mm and 0.4° (PFG). Adding the robot and instruments did not affect the TTFG's position accuracy (p = 0.60), while the PFG's accuracies decreased to 1.5 mm and 0.7° (p < 0.001). For both field generators, when adding robot and instruments, accuracies inside the clinical working volume were higher compared to the entire tracking 3D board volume, 0.7 mm and 0.3° (TTFG), and 1.1 mm and 0.7° (PFG). Introduction of a surgical robot and robotic instruments shows limited distortion of the EMT field, allowing sufficient accuracy for surgical navigation in robotic procedures.
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Affiliation(s)
- L Aguilera Saiz
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands.
| | - H C Groen
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
| | - W J Heerink
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
| | - T J M Ruers
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
- Faculty of Science and Technology (TNW), Nanobiophysics Group (NBP), University of Twente, 7500 AE, Enschede, The Netherlands
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15
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Sluimer J, van den Akker WMR, Goderski G, Swart A, van der Veer B, Cremer J, Chung NH, Molenkamp R, Voermans J, Guldemeester J, Eggink D, Presser LD, Meijer A. High quality of SARS-CoV-2 molecular diagnostics in a diverse laboratory landscape through supported benchmark testing and External Quality Assessment. Sci Rep 2024; 14:1378. [PMID: 38228693 DOI: 10.1038/s41598-023-50912-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024] Open
Abstract
A two-step strategy combining assisted benchmark testing (entry controls) and External Quality Assessments (EQAs) with blinded simulated clinical specimens to enhance and maintain the quality of nucleic acid amplification testing was developed. This strategy was successfully applied to 71 diagnostic laboratories in The Netherlands when upscaling the national diagnostic capacity during the SARS-CoV-2 pandemic. The availability of benchmark testing in combination with advice for improvement substantially enhanced the quality of the laboratory testing procedures for SARS-CoV-2 detection. The three subsequent EQA rounds demonstrated high quality testing with regard to specificity (99.6% correctly identified) and sensitivity (93.3% correctly identified). Even with the implementation of novel assays, changing workflows using diverse equipment and a high degree of assay heterogeneity, the overall high quality was maintained using this two-step strategy. We show that in contrast to the limited value of Cq value for absolute proxies of viral load, these Cq values can, in combination with metadata on strategies and techniques, provide valuable information for laboratories to improve their procedures. In conclusion, our two-step strategy (preparation phase followed by a series of EQAs) is a rapid and flexible system capable of scaling, improving, and maintaining high quality diagnostics even in a rapidly evolving (e.g. pandemic) situation.
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Grants
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
- V/190028/22/PR Ministerie van Volksgezondheid, Welzijn en Sport
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Affiliation(s)
- John Sluimer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Willem M R van den Akker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Gabriel Goderski
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Arno Swart
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Bas van der Veer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jeroen Cremer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ngoc Hoa Chung
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Richard Molenkamp
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jolanda Voermans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Judith Guldemeester
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dirk Eggink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Lance D Presser
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Adam Meijer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
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Arrahmani F, Gorter A, Elberse J, Buitenhuis AH, Kok G, Spruijt P. Crossroads of well-being and compliance: a qualitative cohort study of visitor restriction policy during the COVID-19 pandemic, the Netherlands, May 2020-December 2021. BMC Public Health 2024; 24:175. [PMID: 38218791 PMCID: PMC10787453 DOI: 10.1186/s12889-024-17665-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/04/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND In this qualitative study we observed in-depth the impact of the visiting restriction policy (VRP, i.e. number of visitors allowed at home) on well-being and compliance during the COVID-19 pandemic to regulate infection rates. METHODS A cohort of 15 interviewees was followed throughout the COVID-19 pandemic in the Netherlands in 12 interview rounds (May 2020-December 2021). Every round semi-structured telephone interviews were conducted by a team of 8 researchers. In total 176 interviews were conducted. RESULTS This study showed that four categories can be identified when observing the impact of the VRP on well-being and compliance. For Resilient-Followers reasons for compliance were risk perception, following government rules, and for some having a small social circle. Because they accepted the situation, well-being was hardly affected. Resilient-Rulebreakers made their own risk assessment of people they met. Their well-being was hardly affected, because they experienced social rest and interpreted the measure in their own way. Suffering-Followers complied, because of risk perception, following government rules, and working in healthcare. However, the VRP had substantial impact on well-being, because social structures were disrupted. Suffering-Rulebreakers gave their own interpretation to the VRP, trying to find a balance between compliance and well-being. We observed that the categories were quite stable over time. CONCLUSIONS The VRP appeared to be a measure with substantial impact on well-being for some, mostly because social structures were disrupted. The measure showed fluctuating compliance, in which feasibility and frequent changes in the VRP played a role. Well-being seemed related to the number of visitors that was allowed; a restriction of four visitors was feasible, while one visitor resulted in a negative breaking-point in resilience, which had an impact on compliance, even among the most compliant. Taken together, this study provides valuable insights into the implications of and compliance to a VRP during different phases of the COVID-19 pandemic, which may contribute to policymaking during future pandemics.
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Affiliation(s)
- Fatima Arrahmani
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
| | - Annerike Gorter
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
| | - Janneke Elberse
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
| | - Anne H Buitenhuis
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
| | - Gerjo Kok
- Applied Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Pita Spruijt
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
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17
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Wang Y, Dackus GMHE, Rosenberg EH, Cornelissen S, de Boo LW, Broeks A, Brugman W, Chan TWS, van Diest PJ, Hauptmann M, Ter Hoeve ND, Isaeva OI, de Jong VMT, Jóźwiak K, Kluin RJC, Kok M, Koop E, Nederlof PM, Opdam M, Schouten PC, Siesling S, van Steenis C, Voogd AC, Vreuls W, Salgado RF, Linn SC, Schmidt MK. Long-term outcomes of young, node-negative, chemotherapy-naïve, triple-negative breast cancer patients according to BRCA1 status. BMC Med 2024; 22:9. [PMID: 38191387 PMCID: PMC10775514 DOI: 10.1186/s12916-023-03233-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Due to the abundant usage of chemotherapy in young triple-negative breast cancer (TNBC) patients, the unbiased prognostic value of BRCA1-related biomarkers in this population remains unclear. In addition, whether BRCA1-related biomarkers modify the well-established prognostic value of stromal tumor-infiltrating lymphocytes (sTILs) is unknown. This study aimed to compare the outcomes of young, node-negative, chemotherapy-naïve TNBC patients according to BRCA1 status, taking sTILs into account. METHODS We included 485 Dutch women diagnosed with node-negative TNBC under age 40 between 1989 and 2000. During this period, these women were considered low-risk and did not receive chemotherapy. BRCA1 status, including pathogenic germline BRCA1 mutation (gBRCA1m), somatic BRCA1 mutation (sBRCA1m), and tumor BRCA1 promoter methylation (BRCA1-PM), was assessed using DNA from formalin-fixed paraffin-embedded tissue. sTILs were assessed according to the international guideline. Patients' outcomes were compared using Cox regression and competing risk models. RESULTS Among the 399 patients with BRCA1 status, 26.3% had a gBRCA1m, 5.3% had a sBRCA1m, 36.6% had tumor BRCA1-PM, and 31.8% had BRCA1-non-altered tumors. Compared to BRCA1-non-alteration, gBRCA1m was associated with worse overall survival (OS) from the fourth year after diagnosis (adjusted HR, 2.11; 95% CI, 1.18-3.75), and this association attenuated after adjustment for second primary tumors. Every 10% sTIL increment was associated with 16% higher OS (adjusted HR, 0.84; 95% CI, 0.78-0.90) in gBRCA1m, sBRCA1m, or BRCA1-non-altered patients and 31% higher OS in tumor BRCA1-PM patients. Among the 66 patients with tumor BRCA1-PM and ≥ 50% sTILs, we observed excellent 15-year OS (97.0%; 95% CI, 92.9-100%). Conversely, among the 61 patients with gBRCA1m and < 50% sTILs, we observed poor 15-year OS (50.8%; 95% CI, 39.7-65.0%). Furthermore, gBRCA1m was associated with higher (adjusted subdistribution HR, 4.04; 95% CI, 2.29-7.13) and tumor BRCA1-PM with lower (adjusted subdistribution HR, 0.42; 95% CI, 0.19-0.95) incidence of second primary tumors, compared to BRCA1-non-alteration. CONCLUSIONS Although both gBRCA1m and tumor BRCA1-PM alter BRCA1 gene transcription, they are associated with different outcomes in young, node-negative, chemotherapy-naïve TNBC patients. By combining sTILs and BRCA1 status for risk classification, we were able to identify potential subgroups in this population to intensify and optimize adjuvant treatment.
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Affiliation(s)
- Yuwei Wang
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Gwen M H E Dackus
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Efraim H Rosenberg
- Division of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sten Cornelissen
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Leonora W de Boo
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Annegien Broeks
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wim Brugman
- Genomics Core Facility, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Terry W S Chan
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Natalie D Ter Hoeve
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Olga I Isaeva
- Division of Tumor Biology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Vincent M T de Jong
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Katarzyna Jóźwiak
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Roelof J C Kluin
- Genomics Core Facility, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marleen Kok
- Division of Tumor Biology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Esther Koop
- Department of Pathology, Gelre Ziekenhuizen, Apeldoorn, The Netherlands
| | - Petra M Nederlof
- Division of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Mark Opdam
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Philip C Schouten
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | | | - Adri C Voogd
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Willem Vreuls
- Department of Pathology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - Roberto F Salgado
- Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium
- Division of Research, Peter MacCallum Cancer Center, Melbourne, Australia
| | - Sabine C Linn
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marjanka K Schmidt
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
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Broekharst DSE, Stoop A, Achterberg WP, Caljouw MAA. An exploration of relocation initiatives deployed within and between nursing homes: a qualitative study. BMC Health Serv Res 2024; 24:22. [PMID: 38178063 PMCID: PMC10768348 DOI: 10.1186/s12913-023-10505-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Relocations within and between nursing homes often induce stress, anxiety, and depression in residents and cause additional workload for and burnout in staff. To prevent this, many nursing homes deploy pre-transition initiatives, bridging initiatives, and post-transition initiatives to support residents and staff during the relocation process. As little is known about these initiatives, this study aims to explore the pre-relocation, bridging and post-relocation initiatives used for relocations within and between nursing homes. METHODS In seven Dutch nursing homes, eight focus groups were conducted with two to six participants (N = 37) who were actively involved in relocation processes in different roles (i.e., managers, healthcare professionals, support staff, client council members, residents and family). The focus groups were conducted based on a predefined topic list and lasted approximately 60 min. The transcripts were recorded, transcribed verbatim and analysed using thematic coding. RESULTS Nursing homes had to be inventive in developing relocation initiatives as neither shared guidelines nor knowledge exchange on this topic were available. A total of thirty-seven relocation initiatives were identified in these seven nursing homes. Nineteen pre-relocation initiatives were identified, of which eight emphasized information and engagement, three highlighted training and practice and eight stressed orientation and visualization. Seven bridging initiatives were identified, of which four emphasized coordination and continuity and three highlighted entertainment and celebration. Eleven post-relocation initiatives were identified, of which seven emphasized evaluation and troubleshooting and four highlighted change and adjustment. CONCLUSION The identified relocation initiatives were developed unassisted by nursing homes, due to a lack of shared guidelines, knowledge exchange and mutual learning on this topic. Therefore, it may be expedient and more effective to develop general guidelines for relocations within and between nursing homes in collaboration with nursing homes.
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Affiliation(s)
- Damien S E Broekharst
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands.
- University Network for the Care Sector South Holland, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands.
| | - Annerieke Stoop
- Academic Collaborative Centre Older Adults, Tranzo Scientific Centre for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- University Network for the Care Sector South Holland, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
| | - Monique A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- University Network for the Care Sector South Holland, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
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de Feijter M, van Gelder MMHJ, Vissers LCM, Kant AC, Woestenberg PJ. The risk of miscarriage after COVID-19 vaccination before and during pregnancy. Pharmacoepidemiol Drug Saf 2024; 33:e5724. [PMID: 37946587 DOI: 10.1002/pds.5724] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Pregnant women are at higher risk of severe illness and adverse pregnancy outcomes due to a SARS-CoV-2 infection, which can be prevented by vaccination. Observational studies are needed to ascertain the safety of COVID-19 vaccination during pregnancy. We aimed to determine whether COVID-19 vaccination before and during pregnancy is associated with the risk of miscarriage. METHODS In this cohort study, we included 4640 pregnant women (mean age: 32.8 ± 3.7 years) from the Dutch Pregnancy Drug Register between February 2021 and August 2022. Information on COVID-19 vaccinations, miscarriage, and confounders was self-reported, using web-based questionnaires. The hazard ratio (HR) of miscarriage (in gestational weeks 6-20) after a COVID-19 vaccination, was estimated using the survival analyses. A COVID-19 vaccination during pregnancy (≥1 COVID-19 vaccination between week 2 and 20 of pregnancy) was included as a time-dependent exposure and vaccination prior to pregnancy was included as a binary exposure. RESULTS A total of 3202 pregnant women (69%) received ≥1 COVID-19 vaccine in gestational week 2-20. We observed no association of vaccination during pregnancy with the risk of miscarriage (adjusted HR = 1.29, 95% CI = 0.93-1.74). Vaccination prior to pregnancy, however, was associated with a decreased risk of miscarriage (adjusted HR = 0.69, 95% CI = 0.48-0.99). CONCLUSIONS We demonstrated that COVID-19 vaccination during pregnancy is not associated with an increased risk of miscarriage in gestational weeks 6-20. This study adds to the growing body of evidence demonstrating the safety of COVID-19 vaccination during pregnancy.
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Affiliation(s)
- Maud de Feijter
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | | | - Lieke C M Vissers
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Agnes C Kant
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
- Department of Clinical Pharmacology and Toxicology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Petra J Woestenberg
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
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Teuwen MMH, van Weely SFE, Vliet Vlieland TPM, Douw T, van Schaardenburg D, den Broeder AA, van Tubergen AM, van Wissen MAT, van den Ende CHM, Gademan MGJ. Functional limitations of people with rheumatoid arthritis or axial spondyloarthritis and severe functional disability: a cross-sectional descriptive study. Rheumatol Int 2024; 44:129-143. [PMID: 38006457 PMCID: PMC10766716 DOI: 10.1007/s00296-023-05487-z] [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] [Received: 08/14/2023] [Accepted: 10/03/2023] [Indexed: 11/27/2023]
Abstract
The objective of the study is to describe the nature of functional limitations in activities and participation in people with Rheumatoid Arthritis (RA) or axial SpondyloArthritis (axSpA) with severe functional disability. Baseline data from people with RA (n = 206) or axSpA (n = 155) and severe functional disability participating in an exercise trial were used. Their three most limited activities were derived from the Patient Specific Complaint (PSC) instrument and linked to the International Classification of Functioning and Health (ICF). The frequencies of ICF categories were calculated and compared with Activities and Participation items of the ICF Core Sets for RA (32 second-level categories) and Ankylosing Spondylitis (AS) (24 second-level categories). In total 618 and 465 PSC activities were linked to 909 (72 unique in total; 25 unique second-level) and 759 (57 unique in total; 23 unique second-level) ICF categories in RA and axSpA. Taking into account all three prioritized activities, the five most frequent limited activities concerned the ICF chapter "Mobility", and included "Walking" (RA and axSpA 2 categories), "Changing basic body position" (RA and axSpA 1 category), "Stair climbing"(RA) and "Grasping" (RA),"Lifting" (axSpA) and "Maintaining a standing position" (axSpA). In RA, 21/32 (66%) and in axSpA 14/24 (58%) unique second-level categories identified in the prioritized activities are present in the Comprehensive Core Sets. Most limitations of people with RA or axSpA and severe functional disability were seen in the ICF chapter "Mobility". Most of the identified ICF categories were covered by the corresponding items of the ICF RA and AS Core Sets.
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Affiliation(s)
- Max M H Teuwen
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300, RC, Leiden, The Netherlands.
| | - Salima F E van Weely
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300, RC, Leiden, The Netherlands
| | - Thea P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300, RC, Leiden, The Netherlands
| | - Thom Douw
- University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Dirkjan van Schaardenburg
- Department of Rheumatology, Center for Rehabilitation and Rheumatology, Reade, Amsterdam, The Netherlands
| | | | - Astrid M van Tubergen
- Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Maria A T van Wissen
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300, RC, Leiden, The Netherlands
| | - Cornelia H M van den Ende
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Maaike G J Gademan
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300, RC, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
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21
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Röthlisberger D, Jungo KT, Bütikofer L, Poortvliet RKE, Gussekloo J, Streit S. Association of low blood pressure and falls: An analysis of data from the Leiden 85-plus Study. PLoS One 2023; 18:e0295976. [PMID: 38117755 PMCID: PMC10732458 DOI: 10.1371/journal.pone.0295976] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/28/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Falls and consequent injuries are prevalent in older adults. In this group, half of injury-related hospitalizations are associated with falls and the rate of falls increases with age. The evidence on the role of blood pressure and the use of antihypertensive treatment on the risk of falls remains unclear in oldest-old adults (≥85 years). OBJECTIVES To examine the association between systolic blood pressure (SBP) and incident falls with medical consequences in oldest-old adults and to analyse whether this association is modified by the use of antihypertensive treatments or the presence of cardiovascular disease. METHODS We analysed data from the Leiden 85-plus Study, a prospective, population-based cohort study with adults aged ≥85 years and a 5-year follow-up. Falls with medical consequences were reported by the treating physician of participants. We assessed the association between time-updated systolic blood pressure and the risk of falling over a follow-up period of five years using generalized linear mixed effects models with a binomial distribution and a logit link function. Subgroup analyses were performed to examine the role of antihypertensive treatment and the difference between participant with and without cardiovascular disease. RESULTS We analysed data from 544 oldest-old adults, 242 (44.4%) of which used antihypertensives. In 81 individuals (15%) ≥1 fall(s) were reported during the follow-up period. The odds for a fall decreased by a factor of 0.86 (95% CI 0.80 to 0.93) for each increase in blood pressure by 10 mmHg. This effect was specific to blood pressure values above 130mmHg. We did not find any evidence that the effect would be modified by antihypertensive treatment, but that there was a tendency that it would be weaker in participants with cardiovascular disease (OR 0.81, 95% CI 0.72 to 0.90 per 10mmHg) compared to those without cardiovascular disease (OR 0.94, 95% CI 0.84 to 1.05 per 10mmHg). CONCLUSION Our results point towards a possible benefit of higher blood pressure in the oldest-old with respect to falls independent of the use of antihypertensive treatments.
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Affiliation(s)
- David Röthlisberger
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | | | | | | | - Jacobijn Gussekloo
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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22
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Onken M, Lohse L, Coulm B, Beghin D, Richardson JL, Bermejo-Sánchez E, Aguilera C, Bosch M, Cassina M, Chouchana L, De Santis M, Duman MK, Gören MZ, Johnson D, Bera APJ, Kaplan YC, Kennedy D, Kwok S, Lacroix I, Lepelley M, Pistelli A, Schaefer C, Te Winkel B, Uysal N, Winterfeld U, Yakuwa N, Diav-Citrin O, Vial T, Dathe K. Effects of maternal modafinil treatment on fetal development and neonatal growth parameters - a multicenter case series of the European Network of Teratology Information Services (ENTIS). Acta Psychiatr Scand 2023. [PMID: 38110225 DOI: 10.1111/acps.13643] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE In recent years, safety concerns about modafinil exposure during pregnancy have emerged. In particular, increased risks for major congenital anomalies (MCA) and impaired fetal growth were reported, although study results were conflicting. Our investigation aims to examine previously reported safety signals. METHOD Multicenter case series based on data from 18 Teratology Information Services from 12 countries. Modafinil exposed pregnancies with an estimated date of birth before August 2019 were included in this study. For prospectively ascertained pregnancies, cumulative incidences of pregnancy outcomes, rate of nonchromosomal MCA in first trimester exposed pregnancies and percentiles of neonatal/infant weight and head circumference (HC) were calculated. Potential dose-dependent effects on fetal growth were explored by linear regression models. Retrospectively ascertained cases were screened for pattern of MCA and other adverse events. RESULTS One hundred and seventy-five prospectively ascertained cases were included, of which 173 were exposed at least during the first trimester. Cumulative incidences for live birth, spontaneous abortion and elective termination of pregnancy were 76.9% (95% CI, 68.0%-84.8%), 9.3% (95% CI, 5.0%-16.9%), and 13.9% (95% CI, 8.1%-23.1%), respectively. Nonchromosomal MCA was present in 3/150 live births, corresponding to an MCA rate of 2.0% (95%CI, 0.6%-6.1%), none were reported in pregnancy losses. Compared to reference standards, birth weight (BW) tended to be lower and neonatal HC to be smaller in exposed newborns (data available for 144 and 73 of 153 live births, respectively). In nonadjusted linear regression models, each 100 mg increase of average dosage per pregnancy day was associated with a decrease in standard deviation score (SDS) of -0.28 SDS (95% CI, -0.45 to -0.10) for BW and of -0.28 SDS (95% CI, -0.56 to 0.01) for HC. Screening of 22 retrospectively reported cases did not reveal any specific pattern of MCA or other adverse outcomes. CONCLUSION The results do not indicate an increased risk of MCA after in utero exposure to modafinil, but a tendency toward lower BW and reduced neonatal HC. However, these findings should be regarded as preliminary. Until further studies allow for a definite conclusion, modafinil should not be used during pregnancy.
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Affiliation(s)
- Marlies Onken
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
| | - Lukas Lohse
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
| | - Bénédicte Coulm
- AP-HP.Sorbonne Université, Hôpital Trousseau, Département de Santé Publique, Centre de Référence sur les Agents Tératogènes (CRAT), Paris, France
| | - Delphine Beghin
- AP-HP.Sorbonne Université, Hôpital Trousseau, Département de Santé Publique, Centre de Référence sur les Agents Tératogènes (CRAT), Paris, France
| | - Jonathan L Richardson
- UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Eva Bermejo-Sánchez
- Institute of Rare Diseases Research (IIER), Research Unit on Congenital Anomalies-UIAC and Spanish Teratology Information Services SITTE and SITE, Instituto Salud Carlos III (ISCIII), Madrid, Spain
| | - Cristina Aguilera
- Clinical Pharmacology Service, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Montserrat Bosch
- Clinical Pharmacology Service, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Matteo Cassina
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Laurent Chouchana
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de pharmacologie périnatale, pédiatrique et adulte, Centre Régional de Pharmacovigilance, Paris, France
| | - Marco De Santis
- Teratology Information Service, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Mine Kadioglu Duman
- Teratology Information Service, Department of Pharmacology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - M Zafer Gören
- Department of Medical Pharmacology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Diana Johnson
- Department of Pediatrics, University of California, San Diego, California, USA
| | - Annie Pierre Jonville Bera
- Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance Centre-Val de Loire, Tours, France
| | - Yusuf C Kaplan
- Department of Pharmacology, Izmir Katip Celebi University School of Medicine, Training and Research Center, Izmir, Turkey
| | - Debra Kennedy
- MotherSafe, The Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Susan Kwok
- MotherSafe, The Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Isabelle Lacroix
- Service de pharmacologie médicale et clinique, centre régional de pharmacovigilance, faculté de médecine, CHU de Toulouse, Toulouse, France
| | - Marion Lepelley
- Université Grenoble Alpes, Centre régional de pharmacovigilance, Grenoble, France
| | - Alessandra Pistelli
- Toxicology Unit and Poison Control Centre, Teratology Information Service, Careggi University Hospital, Florence, Italy
| | - Christof Schaefer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
| | - Bernke Te Winkel
- Teratology Information Service, Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Nusret Uysal
- Department of Pharmacology, Izmir Katip Celebi University School of Medicine, Training and Research Center, Izmir, Turkey
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service de Pharmacologie Clinique, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Naho Yakuwa
- Japan Drug Information Institute in Pregnancy, National Center for Child Health and Development, Tokyo, Japan
| | - Orna Diav-Citrin
- The Israeli Teratology Information Service, Ministry of Health, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Thierry Vial
- Pharmacovigilance Center, Hospital University Pharmacotoxicology Department, Lyon, France
| | - Katarina Dathe
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
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Tsang VMW, Verlinden E, Brilleslijper-Kater SN, van Duin EM, Twisk JWR, Verhoeff AP, Lindauer RJL. A Longitudinal Study in Worrisome Sexual Behavior Following Sexual Abuse in Infancy or Early Childhood: The Amsterdam Sexual Abuse Case. J Child Adolesc Trauma 2023; 16:1053-1063. [PMID: 38045842 PMCID: PMC10689610 DOI: 10.1007/s40653-023-00539-9] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 12/05/2023]
Abstract
Worrisome sexual behavior (WSB) is often described as an outcome specific to child sexual abuse (CSA). Therefore, it is highly relevant to study WSB in relation to sexual abuse, especially in very young children, as it is hard to recognize sexual abuse in children who have limited verbal capacities of disclosing. Over time, literature describing WSB following CSA has gradually broadened. However, a gap remains regarding the long-term development of WSB in children who were sexually abused during infancy or very early childhood. To our knowledge, our study is the first to examine developmentally-related sexual behavior versus sexual abuse-specific behavior longitudinally in children who were sexually abused at a very young age. In total, we examined the sexual behavior, as reported by parents of 45 children who experienced early-age sexual abuse for a period of more than five years. Overall, we found that WSB is likely to be a CSA-specific and potentially long-term outcome for children who were sexually abused at a very young age. Despite the decrease in sexual abuse-specific behavior over time, the level of this behavior was still significantly high 8 years after the sexual abuse. This finding supports long-term monitoring and assessment and intervention for WSB over time. Despite these findings, it is important to note that WSB does not serve as proof of sexual abuse in children; likewise, when a child does not present with WSB, it does not indicate the absence of a substantiated history of sexual abuse.
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Affiliation(s)
- Vionna M. W. Tsang
- Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Eva Verlinden
- Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
- Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands
| | - Sonja N. Brilleslijper-Kater
- Amsterdam UMC, Department of Social Pediatrics, Child Abuse and Neglect Team, University of Amsterdam, Amsterdam, the Netherlands
| | - Esther M. van Duin
- Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Jos W. R. Twisk
- Amsterdam UMC, Department of Clinical Epidemiology and Biostatistics, VU University, Amsterdam, the Netherlands
| | - Arnoud P. Verhoeff
- Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands
- Department of Sociology, University of Amsterdam, Amsterdam, the Netherlands
| | - Ramón J. L. Lindauer
- Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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24
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Lopera-Maya EA, Li S, de Brouwer R, Nolte IM, van Breen J, Jongbloed JDH, Swertz MA, Snieder H, Franke L, Wijmenga C, de Boer RA, Deelen P, van der Zwaag PA, Sanna S. Phenotypic and Genetic Factors Associated with Absence of Cardiomyopathy Symptoms in PLN:c.40_42delAGA Carriers. J Cardiovasc Transl Res 2023; 16:1251-1266. [PMID: 36622581 PMCID: PMC10721704 DOI: 10.1007/s12265-022-10347-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/14/2022] [Indexed: 01/10/2023]
Abstract
The c.40_42delAGA variant in the phospholamban gene (PLN) has been associated with dilated and arrhythmogenic cardiomyopathy, with up to 70% of carriers experiencing a major cardiac event by age 70. However, there are carriers who remain asymptomatic at older ages. To understand the mechanisms behind this incomplete penetrance, we evaluated potential phenotypic and genetic modifiers in 74 PLN:c.40_42delAGA carriers identified in 36,339 participants of the Lifelines population cohort. Asymptomatic carriers (N = 48) showed shorter QRS duration (- 5.73 ms, q value = 0.001) compared to asymptomatic non-carriers, an effect we could replicate in two different independent cohorts. Furthermore, symptomatic carriers showed a higher correlation (rPearson = 0.17) between polygenic predisposition to higher QRS (PGSQRS) and QRS (p value = 1.98 × 10-8), suggesting that the effect of the genetic variation on cardiac rhythm might be increased in symptomatic carriers. Our results allow for improved clinical interpretation for asymptomatic carriers, while our approach could guide future studies on genetic diseases with incomplete penetrance.
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Affiliation(s)
- Esteban A Lopera-Maya
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Shuang Li
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Remco de Brouwer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ilja M Nolte
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Justin van Breen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jan D H Jongbloed
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Morris A Swertz
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Genomics Coordination Center, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Lude Franke
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Cisca Wijmenga
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Patrick Deelen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Oncode Institute, Utrecht, Netherlands
| | - Paul A van der Zwaag
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
| | - Serena Sanna
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
- Institute for Genetic and Biomedical Research (IRGB), National Research Council (CNR), Cagliari, Italy.
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25
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Ter Haar W, Bosdriesz J, Venekamp RP, Schuit E, van den Hof S, Ebbers W, Kretzschmar M, Kluijtmans J, Moons C, Schim van der Loeff M, Matser A, van de Wijgert JHHM. The epidemiological impact of digital and manual contact tracing on the SARS-CoV-2 epidemic in the Netherlands: Empirical evidence. PLOS Digit Health 2023; 2:e0000396. [PMID: 38157381 PMCID: PMC10756539 DOI: 10.1371/journal.pdig.0000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
The Dutch government introduced the CoronaMelder smartphone application for digital contact tracing (DCT) to complement manual contact tracing (MCT) by Public Health Services (PHS) during the 2020-2022 SARS-CoV-2 epidemic. Modelling studies showed great potential but empirical evidence of DCT and MCT impact is scarce. We determined reasons for testing, and mean exposure-testing intervals by reason for testing, using routine data from PHS Amsterdam (1 December 2020 to 31 May 2021) and data from two SARS-CoV-2 rapid diagnostic test accuracy studies at other PHS sites in the Netherlands (14 December 2020 to 18 June 2021). Throughout the study periods, notification of DCT-identified contacts was via PHS contact-tracers, and self-testing was not yet widely available. The most commonly reported reason for testing was having symptoms. In asymptomatic individuals, it was having been warned by an index case. Only around 2% and 2-5% of all tests took place after DCT or MCT notification, respectively. About 20-36% of those who had received a DCT or MCT notification had symptoms at the time of test request. Test positivity after a DCT notification was significantly lower, and exposure-test intervals after a DCT or MCT notification were longer, than for the above-mentioned other reasons for testing. Our data suggest that the impact of DCT and MCT on the SARS-CoV-2 epidemic in the Netherlands was limited. However, DCT impact might be enlarged if app use coverage is improved, contact-tracers are eliminated from the digital notification process to minimise delays, and DCT is combined with self-testing.
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Affiliation(s)
- Wianne Ter Haar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Public Health Service (GGD) of Amsterdam, Amsterdam, Netherlands
| | - Jizzo Bosdriesz
- Public Health Service (GGD) of Amsterdam, Amsterdam, Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Roderick P. Venekamp
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Ewoud Schuit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Susan van den Hof
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Wolfgang Ebbers
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Mirjam Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jan Kluijtmans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Carl Moons
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Maarten Schim van der Loeff
- Public Health Service (GGD) of Amsterdam, Amsterdam, Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Amy Matser
- Public Health Service (GGD) of Amsterdam, Amsterdam, Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Janneke H. H. M. van de Wijgert
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
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26
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Levi H, Carmi S, Rosset S, Yerushalmi R, Zick A, Yablonski-Peretz T, Wang Q, Bolla MK, Dennis J, Michailidou K, Lush M, Ahearn T, Andrulis IL, Anton-Culver H, Antoniou AC, Arndt V, Augustinsson A, Auvinen P, Beane Freeman L, Beckmann M, Behrens S, Bermisheva M, Bodelon C, Bogdanova NV, Bojesen SE, Brenner H, Byers H, Camp N, Castelao J, Chang-Claude J, Chirlaque MD, Chung W, Clarke C, Collee MJ, Colonna S, Couch F, Cox A, Cross SS, Czene K, Daly M, Devilee P, Dork T, Dossus L, Eccles DM, Eliassen AH, Eriksson M, Evans G, Fasching P, Fletcher O, Flyger H, Fritschi L, Gabrielson M, Gago-Dominguez M, García-Closas M, Garcia-Saenz JA, Genkinger J, Giles GG, Goldberg M, Guénel P, Hall P, Hamann U, He W, Hillemanns P, Hollestelle A, Hoppe R, Hopper J, Jakovchevska S, Jakubowska A, Jernström H, John E, Johnson N, Jones M, Vijai J, Kaaks R, Khusnutdinova E, Kitahara C, Koutros S, Kristensen V, Kurian AW, Lacey J, Lambrechts D, Le Marchand L, Lejbkowicz F, Lindblom A, Loibl S, Lori A, Lubinski J, Mannermaa A, Manoochehri M, Mavroudis D, Menon U, Mulligan A, Murphy R, Nevelsteen I, Newman WG, Obi N, O'Brien K, Offit K, Olshan A, Plaseska-Karanfilska D, Olson J, Panico S, Park-Simon TW, Patel A, Peterlongo P, Rack B, Radice P, Rennert G, Rhenius V, Romero A, Saloustros E, Sandler D, Schmidt MK, Schwentner L, Shah M, Sharma P, Simard J, Southey M, Stone J, Tapper WJ, Taylor J, Teras L, Toland AE, Troester M, Truong T, van der Kolk LE, Weinberg C, Wendt C, Yang XR, Zheng W, Ziogas A, Dunning AM, Pharoah P, Easton DF, Ben-Sachar S, Elefant N, Shamir R, Elkon R. Evaluation of European-based polygenic risk score for breast cancer in Ashkenazi Jewish women in Israel. J Med Genet 2023; 60:1186-1197. [PMID: 37451831 PMCID: PMC10715538 DOI: 10.1136/jmg-2023-109185] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/28/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Polygenic risk score (PRS), calculated based on genome-wide association studies (GWASs), can improve breast cancer (BC) risk assessment. To date, most BC GWASs have been performed in individuals of European (EUR) ancestry, and the generalisation of EUR-based PRS to other populations is a major challenge. In this study, we examined the performance of EUR-based BC PRS models in Ashkenazi Jewish (AJ) women. METHODS We generated PRSs based on data on EUR women from the Breast Cancer Association Consortium (BCAC). We tested the performance of the PRSs in a cohort of 2161 AJ women from Israel (1437 cases and 724 controls) from BCAC (BCAC cohort from Israel (BCAC-IL)). In addition, we tested the performance of these EUR-based BC PRSs, as well as the established 313-SNP EUR BC PRS, in an independent cohort of 181 AJ women from Hadassah Medical Center (HMC) in Israel. RESULTS In the BCAC-IL cohort, the highest OR per 1 SD was 1.56 (±0.09). The OR for AJ women at the top 10% of the PRS distribution compared with the middle quintile was 2.10 (±0.24). In the HMC cohort, the OR per 1 SD of the EUR-based PRS that performed best in the BCAC-IL cohort was 1.58±0.27. The OR per 1 SD of the commonly used 313-SNP BC PRS was 1.64 (±0.28). CONCLUSIONS Extant EUR GWAS data can be used for generating PRSs that identify AJ women with markedly elevated risk of BC and therefore hold promise for improving BC risk assessment in AJ women.
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Grants
- R01 CA176785 NCI NIH HHS
- NU58DP006344 NCCDPHP CDC HHS
- R37 CA070867 NCI NIH HHS
- HHSN261201800015I NCI NIH HHS
- R01 CA064277 NCI NIH HHS
- P50 CA116201 NCI NIH HHS
- G1000143 Medical Research Council
- P30 CA062203 NCI NIH HHS
- HHSN261201800015C NCI NIH HHS
- R01 CA047305 NCI NIH HHS
- HHSN261201800009I NCI NIH HHS
- R01 CA163353 NCI NIH HHS
- UM1 CA164917 NCI NIH HHS
- U01 CA199277 NCI NIH HHS
- U01 CA179715 NCI NIH HHS
- HHSN261201800032C NCI NIH HHS
- U54 CA156733 NCI NIH HHS
- HHSN261201800009C NCI NIH HHS
- Z01 CP010119 Intramural NIH HHS
- UM1 CA164973 NCI NIH HHS
- P01 CA087969 NCI NIH HHS
- UM1 CA164920 NCI NIH HHS
- NU58DP006320 CDC HHS
- UM1 CA176726 NCI NIH HHS
- R01 CA092447 NCI NIH HHS
- Z01 ES049030 Intramural NIH HHS
- R01 CA058860 NCI NIH HHS
- K07 CA092044 NCI NIH HHS
- HHSN261201800016C NCI NIH HHS
- P50 CA058223 NCI NIH HHS
- R01 CA100374 NCI NIH HHS
- P30 CA008748 NCI NIH HHS
- R01 CA128978 NCI NIH HHS
- R01 CA047147 NCI NIH HHS
- U19 CA148537 NCI NIH HHS
- R01 CA116167 NCI NIH HHS
- R01 CA148667 NCI NIH HHS
- R01 CA063464 NCI NIH HHS
- HHSN261201800016I NCI NIH HHS
- UM1 CA186107 NCI NIH HHS
- P30 CA023100 NCI NIH HHS
- U01 CA063464 NCI NIH HHS
- R01 CA077398 NCI NIH HHS
- R01 CA054281 NCI NIH HHS
- R01 CA132839 NCI NIH HHS
- P30 CA068485 NCI NIH HHS
- U01 CA058860 NCI NIH HHS
- U01 CA164920 NCI NIH HHS
- R35 CA253187 NCI NIH HHS
- 14136 Cancer Research UK
- U19 CA148112 NCI NIH HHS
- HHSN261201800032I NCI NIH HHS
- U01 CA098758 NCI NIH HHS
- Z01 ES044005 Intramural NIH HHS
- U19 CA148065 NCI NIH HHS
- P30 CA033572 NCI NIH HHS
- R01 CA069664 NCI NIH HHS
- Wellcome Trust
- 001 World Health Organization
- Z01 ES049033 Intramural NIH HHS
- R01 CA192393 NCI NIH HHS
- U01 CA164973 NCI NIH HHS
- R37 CA054281 NCI NIH HHS
- Consellería de Industria Programa Sectorial de Investigación Aplicada
- Statistics Netherlands
- South Eastern Norway Health Authority
- Lower Saxonian Cancer Society
- Lise Boserup Fund
- Heidelberger Zentrum für Personalisierte Onkologie Deutsches Krebsforschungszentrum In Der Helmholtz-Gemeinschaft
- Lon V. Smith Foundation
- Scottish Funding Council
- Komen Foundation
- Claudia von Schilling Foundation for Breast Cancer Research
- Russian Foundation for Basic Research
- Ligue Contre le Cancer
- Sigrid Juselius Foundation
- Kuopion Yliopistollinen Sairaala
- Sheffield Experimental Cancer Medicine Centre
- Stockholm läns landsting
- Department of Health and Human Services (USA)
- Department of Defence (USA)
- Stichting Tegen Kanker
- David F. and Margaret T. Grohne Family Foundation
- Sundhed og Sygdom, Det Frie Forskningsråd
- Stavros Niarchos Foundation
- Post-Cancer GWAS initiative
- Institute of the Ruhr University Bochum
- Instituto de Salud Carlos III
- Institute of Cancer Research
- Public Health Institute
- Fondation du cancer du sein du Québec
- Institut National de la Santé et de la Recherche Médicale
- Pink Ribbon
- Institute for Prevention and Occupational Medicine
- K.G. Jebsen Centre for Breast Cancer Research
- Research Centre for Genetic Engineering and Biotechnology
- Center of Excellence (Finland)
- Robert and Kate Niehaus Clinical Cancer Genetics Initiative
- Rudolf Bartling Foundation
- Center for Disease Control and Prevention (USA)
- Karolinska Institutet
- Norges Forskningsråd
- Robert Bosch Stiftung
- Intramural Research Funds of the National Cancer Institute (USA)
- Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC
- Intramural Research Program of the Division of Cancer Epidemiology and Genetics
- Centre International de Recherche sur le Cancer
- Queensland Cancer Fund
- Red Temática de Investigación Cooperativa en Cáncer
- Intramural Research Program of the National Institutes of Health
- National Health Service (UK)
- Ministerie van Volksgezondheid, Welzijn en Sport
- National cancer institute (USA)
- KWF Kankerbestrijding
- Märit and Hans Rausings Initiative Against Breast Cancer
- Associazione Italiana per la Ricerca sul Cancro
- Fundación Científica Asociación Española Contra el Cáncer
- ERC advanced grant
- Australian National Health and Medical Research Council
- Agence Nationale de la Recherche
- Dutch Prevention Funds,
- Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail
- American Cancer Society
- Dutch Zorg Onderzoek
- Alexander von Humboldt-Stiftung
- Ministerio de Economia y Competitividad (Spain)
- Ministère du Développement Économique, de l’Innovation et de l’Exportation
- Susan G. Komen for the Cure
- Minister of Science and Higher Education
- Medical Research Council UK
- Ministry of Science and Higher Education of the Russian Federation
- Ministry of Science and Higher Education (Sweden)
- Against Breast Cancer
- Mutuelle Générale de l’Education Nationale
- Academy of Finland
- Deutsche Krebshilfe e.V.
- Dietmar-Hopp Foundation,
- Division of Cancer Prevention, National Cancer Institute
- Deutsche Krebshilfe
- World Cancer Research Fund
- Genome Québec
- National Cancer Institute’s Surveillance, Epidemiology and End Results Program
- Breast Cancer Campaign
- National Cancer Research Network
- Berta Kamprad Foundation FBKS
- Bert von Kantzows foundation
- Biomedical Research Centre at Guy’s and St Thomas
- Genome Canada
- Freistaat Sachsen
- Biobanking and Biomolecular Resources Research Infrastructure
- Friends of Hannover Medical School
- Breast Cancer Research Foundation
- California Department of Public Health
- Government of Russian Federation
- Deutsche Forschungsgemeinschaft
- National Institute for Health and Care Research
- National Health and Medical Research Council (Australia)
- German Federal Ministry of Research and Education
- National Institute of Environmental Health Sciences
- Breast Cancer Now
- Seventh Framework Programme
- Transcan
- Centrum för idrottsforskning
- UK National Institute for Health Research Biomedical Research Centre
- University of Crete
- National Breast Cancer Foundation (Finland)
- European Regional Development Fund
- National Breast Cancer Foundation (Australia)
- United States Army Medical Research and Materiel Command
- EU Horizon 2020 Research and Innovation Programme
- Directorate-General XII, Science, Research, and Development
- Baden Württemberg Ministry of Science, Research and Arts
- VicHealth
- Fondo de Investigación Sanitario
- Victorian Breast Cancer Research Consortium.
- Finnish Cancer Foundation
- University of Southern California San Francisco
- Fomento de la Investigación Clínica Independiente
- the Cancer Biology Research Center (CBRC), Djerassi Oncology Center
- Bundesministerium für Bildung und Forschung
- Cancerfonden
- Tel Aviv University Center for AI and Data Science
- University of Oulu
- National Breast Cancer Foundation (JS)
- Safra Center for Bioinformatics
- Fondation de France, Institut National du Cancer
- Israeli Science Foundation
- University of Utah
- National Cancer Center Research and Development Fund (Japan)
- Chief Scientist Office, Scottish Government Health and Social Care Directorate
- Oak Foundation
- Health Research Fund (FIS)
- Ontario Familial Breast Cancer Registry
- New South Wales Cancer Council
- North Carolina University Cancer Research Fund
- Kreftforeningen
- Northern California Breast Cancer Family Registry
- Institut Gustave Roussy
- Huntsman Cancer Institute, University of Utah
- Ovarian Cancer Research Fund
- NIHR Oxford Biomedical Research Centre
- Hellenic Health Foundation
- Oulun Yliopistollinen Sairaala
- Helmholtz Society
- Herlev and Gentofte Hospital
- PSRSIIRI-701
- Helsinki University Hospital Research Fund
- Cancer Council Victoria
- National Research Council (Italy)
- Cancer Council Tasmania
- Cancer Council Western Australia
- Hamburger Krebsgesellschaft
- Gustav V Jubilee foundation
- National Program of Cancer Registries
- Canadian Cancer Society
- Cancer Council South Australia
- Canadian Institutes of Health Research
- Cancer Council NSW
- Guy's & St. Thomas' NHS Foundation Trust
- Netherlands Organisation of Scientific Research
- Cancer Institute NSW
- National Institutes of Health (USA)
- National Research Foundation of Korea
- Syöpäsäätiö
- Cancer Foundation of Western Australia
- Netherlands Cancer Registry (NKR),
- Cancer Fund of North Savo
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Affiliation(s)
- Hagai Levi
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
- Department of Human Molecular Genetics and Biochemistry, Tel Aviv University, Tel Aviv, Israel
| | - Shai Carmi
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Saharon Rosset
- Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
| | - Rinat Yerushalmi
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviad Zick
- Department of oncology, Hadassah Medical Center, Jerusalem, Israel
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tamar Yablonski-Peretz
- Department of oncology, Hadassah Medical Center, Jerusalem, Israel
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Michael Lush
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thomas Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annelie Augustinsson
- Oncology, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Päivi Auvinen
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
- Department of Oncology, Cancer Center, Kuopio University Hospital, Kuopio, Finland
| | - Laura Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Matthias Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
| | - Clara Bodelon
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Natalia V Bogdanova
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Gynaecology Research Unit, Hannover Medical School, Hamburg, Germany
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Helen Byers
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Nicola Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt lake city, UT, USA
| | - Jose Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Wendy Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | - Christine Clarke
- Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Margriet J Collee
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, Netherlands
| | - Sarah Colonna
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt lake city, UT, USA
| | - Fergus Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Angela Cox
- Department of Oncology and Metabolism, Sheffield Institute for Nucleic Acids (SInFoNiA), University of Sheffield, Sheffield, UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mary Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, Netherlands
- Department of Human Genetics, Leiden University Medical, Leiden, Netherlands
| | - Thilo Dork
- Gynaecology Research Unit, Hannover Medical School, Hamburg, Germany
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Diana M Eccles
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gareth Evans
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Peter Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Lin Fritschi
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Jeanine Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, New York, USA
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Mark Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montreal, QU, Canada
| | - Pascal Guénel
- Team 'Exposome and Heredity', CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Wei He
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Hillemanns
- Gynaecology Research Unit, Hannover Medical School, Hamburg, Germany
| | | | - Reiner Hoppe
- Dr Margarete Fischer Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tubingen, Germany
| | - John Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simona Jakovchevska
- Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', Skopje, North Macedonia
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Helena Jernström
- Oncology, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Esther John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Nichola Johnson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Michael Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Joseph Vijai
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russia
| | - Cari Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Vessela Kristensen
- Institute of Clinical Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Allison W Kurian
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - James Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, VIB, Leuven, Belgium
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Flavio Lejbkowicz
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Annika Lindblom
- Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | | | - Adriana Lori
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College, London, UK
| | - AnnaMarie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Rachel Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada
| | - Ines Nevelsteen
- Leuven Multidisciplinary Breast Center, Department of Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - William G Newman
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katie O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Ken Offit
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Janet Olson
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Salvatore Panico
- Dipertimento Di Medicina Clinca e Chirurgia, Federico II University, Naples, Italy
| | | | - Alpa Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM ETS - the AIRC Institute of Molecular Oncology, Milan, Italy
| | - Brigitte Rack
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Gad Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Valerie Rhenius
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Atocha Romero
- Laboratorio de Oncología Molecular, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Dale Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Priyanka Sharma
- Department of Internal Medicine, Division of Medical Oncology, University of Kansas Medical Center, Westwood, KS, USA
| | - Jacques Simard
- Genomics Center, Molecular Medicine, Université Laval, Quebec, Quebec, Canada
| | - Melissa Southey
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - William J Tapper
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jack Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Lauren Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Amanda E Toland
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, OH, USA
| | - Melissa Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thérèse Truong
- Team 'Exposome and Heredity', CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | | | - Clarice Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Camilla Wendt
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Xiaohong Rose Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Paul Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Shay Ben-Sachar
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Clalit Research Institute, Clalit Health Services, Ramat Gan, Israel
| | - Naama Elefant
- Clalit Research Institute, Clalit Health Services, Ramat Gan, Israel
- Department of Genetics, Hadassah Medical Center, Jerusalem, Israel
| | - Ron Shamir
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Ran Elkon
- Department of Human Molecular Genetics and Biochemistry, Tel Aviv University, Tel Aviv, Israel
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Prettner R, Te Molder H, Humă B. How a 'good parent' decides on childhood vaccination. Demonstrating independence and deliberation during Dutch healthcare visits. Sociol Health Illn 2023. [PMID: 37962985 DOI: 10.1111/1467-9566.13725] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/26/2023] [Indexed: 11/16/2023]
Abstract
Childhood vaccination consultations are considered an important phase in parents' decision-making process. To date, only a few empirical studies conducted in the United States have investigated real-life consultations. To address this gap, we recorded Dutch vaccination conversations between healthcare providers and parents during routine health consultations for their newborns. The data were analysed using Conversation Analysis and Discursive Psychology. We found that the topic of vaccination was often initiated with 'Have you already thought about vaccination?' (HYATAV), and that this formulation was consequential for parental identity work. Exploring the interactional trajectories engendered by this initiation format we show that: (1) interlocutors treat the question as consisting of two types of queries, (2) conversational trajectories differ according to which of the queries is attended to and that (3) parents work up a 'good parent' identity in response to HYATAV, by demonstrating that they think about their child's vaccination beforehand and make their decisions independently. Our findings shed new light on the interactional unfolding of parental vaccination decisions.
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Affiliation(s)
- Robert Prettner
- Department of Language, Literature and Communication, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hedwig Te Molder
- Department of Language, Literature and Communication, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bogdana Humă
- Department of Language, Literature and Communication, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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van der Hulst FJP, Brabers AEM, de Jong JD. How is enrollees' trust in health insurers associated with choosing health insurance? PLoS One 2023; 18:e0292964. [PMID: 37917768 PMCID: PMC10621964 DOI: 10.1371/journal.pone.0292964] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023] Open
Abstract
In a healthcare system based on managed competition, health insurers are intended to be the prudent buyers of care on behalf of their enrollees. Equally, citizens are expected to be critical consumers when choosing a health insurance policy. The choice of a health insurance policy may be related to trust in the health insurer, as enrollees must believe that the health insurer will make the right choices for them when it comes to purchasing care. This study aims to investigate how enrollees' trust in health insurers is associated with their choice of a health insurance policy in the Netherlands. We will focus on the switching behaviour of enrollees and the choice of a policy with restrictive conditions. In February 2022, a questionnaire was sent to a representative sample regarding gender and age of the adult Dutch population. In total 1,125 enrollees responded, a response rate of 56%. Respondents were asked about the choices they made in choosing health insurance. Trust in health insurers was measured using the Health Insurer Trust Scale (HITS), a validated multiple item scale. Descriptive statistics, a paired t-test and logistic regression models were conducted to analyse the results. Of all respondents, 35% indicated that they agree, or completely agree, with the statement that they trust health insurers completely. In addition, trust in enrollees' own insurer is slightly higher than trust in other insurers (36.29 vs. 33.59, p<0.001). Furthermore, we found no significant associations between trust in health insurers, and whether enrollees have either switched health insurers or have chosen a policy with restrictive conditions. This study showed that enrollees' trust in health insurance in the Netherlands is relatively low and that trust in their own insurer is slightly higher than trust in other insurers. Furthermore, this study does not show a relationship between trust in health insurers and, either switching health insurers, or choosing a policy with restrictive conditions. Nevertheless, attention for increasing the trust in health insurers might still be important, as low trust may have negative consequences for other elements of the functioning of the healthcare system.
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Affiliation(s)
| | - Anne E. M. Brabers
- Nivel, The Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Judith D. de Jong
- Nivel, The Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Maastricht University, Maastricht, The Netherlands
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Buimer HP, Siebelink NM, Gaasterland A, van Dam K, Smits A, Frederiks K, van der Poel A. Sleep-wake monitoring of people with intellectual disability: Examining the agreement of EMFIT QS and actigraphy. J Appl Res Intellect Disabil 2023; 36:1276-1287. [PMID: 37489295 DOI: 10.1111/jar.13146] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/23/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Gaining insight into sleep-wake patterns of persons with intellectual disabilities is commonly done using wrist actigraphy. For some people, contactless alternatives are needed. This study compares a contactless bed sensor with wrist actigraphy to monitor sleep-wake patterns of people with moderate to profound intellectual disabilities. METHOD Data were collected with EMFIT QS (activity and presence) and MotionWatch 8/Actiwatch 2 (activity, ambient light, and event marker/sleep diary) for 14 nights in 13 adults with moderate-profound intellectual disabilities residing in intramural care. RESULTS In a care-as-usual setting, EMFIT QS and actigraphy assessment show little agreement on sleep-wake variables. CONCLUSION Currently, EMFIT QS should not be considered an alternative to wrist actigraphy for sleep-wake monitoring. Further research is needed into assessing sleep-wake variables using (contactless) technological devices and how the data should be interpreted within the care context to achieve reliable and valid information on sleep-wake patterns of people with intellectual disabilities.
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Affiliation(s)
- Hendrik P Buimer
- Vilans, National Centre of Expertise for Long-term Care, Utrecht, The Netherlands
| | - Nienke M Siebelink
- Academy Het Dorp, Research & Advisory on Technology in Long-term Care, Arnhem, The Netherlands
| | | | - Kirstin van Dam
- Academy Het Dorp, Research & Advisory on Technology in Long-term Care, Arnhem, The Netherlands
| | | | - Kyra Frederiks
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Agnes van der Poel
- Academy Het Dorp, Research & Advisory on Technology in Long-term Care, Arnhem, The Netherlands
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van Vooren NJE, Drewes HW, de Weger E, Bongers IMB, Baan CA. Program managers' perspectives on using knowledge to support population health management initiatives in their development towards health and wellbeing systems: a qualitative study. Health Res Policy Syst 2023; 21:106. [PMID: 37848923 PMCID: PMC10583399 DOI: 10.1186/s12961-023-01057-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/29/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Population health management (PHM) initiatives are more frequently implemented as a means to tackle the growing pressure on healthcare systems in Western countries. These initiatives aim to transform healthcare systems into sustainable health and wellbeing systems. International studies have already identified guiding principles to aid this development. However, translating this knowledge to action remains a challenge. To help address this challenge, the study aims to identify program managers' experiences and their expectations as to the use of this knowledge to support the development process of PHM initiatives. METHODS Semi-structured interviews were held with program managers of ten Dutch PHM initiatives. These Dutch PHM initiatives were all part of a reflexive evaluation study and were selected on the basis of their variety in focus and involved stakeholders. Program managers were asked about their experiences with, and expectations towards, knowledge use to support the development of their initiative. The interviews with the program managers were coded and clustered thematically. RESULTS Three lessons for knowledge use for the development of PHM initiatives were identified: (1) being able to use knowledge regarding the complexity of PHM development requires (external) expertise regarding PHM development and knowledge about the local situation regarding these themes; (2) the dissemination of knowledge about strategies for PHM development requires better guidance for action, by providing more practical examples of actions and consequences; (3) a collective learning process within the PHM initiative is needed to support knowledge being successfully used for action. CONCLUSIONS Disseminating and using knowledge to aid PHM initiatives is complex due to the complexity of the PHM development itself, and the different contextual factors affecting knowledge use in this development. The findings in this study suggest that for empirical knowledge to support PHM development, tailoring knowledge to only program managers' use might be insufficient to support the initiatives' development, as urgency for change amongst the other involved stakeholders is needed to translate knowledge to action. Therefore, including more partners of the initiatives in knowledge dissemination and mobilization processes is advised.
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Affiliation(s)
- N J E van Vooren
- Department of Quality of Care and Health Economics, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
- Tilburg School of Social and Behavioural Sciences, Tranzo, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
| | - H W Drewes
- Siza, PO Box 532, 6800 AM, Arnhem, The Netherlands
| | - E de Weger
- Vrije Universiteit Amsterdam, Athena Instituut, de Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - I M B Bongers
- Tilburg School of Social and Behavioural Sciences, Tranzo, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Mental Health Care Institute Eindhoven, de Kempen, PO Box 909, 5600 AX, Eindhoven, The Netherlands
| | - C A Baan
- Tilburg School of Social and Behavioural Sciences, Tranzo, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
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Krijger A, Schiphof-Godart L, Elstgeest L, van Rossum C, Verkaik-Kloosterman J, Steenbergen E, Ter Borg S, Lanting C, van Drongelen K, Engelse O, Kindermann A, Detmar S, Frenkel C, Raat H, Joosten K. Development and evaluation study of FLY-Kids: a new lifestyle screening tool for young children. Eur J Pediatr 2023; 182:4749-4757. [PMID: 37580556 PMCID: PMC10587277 DOI: 10.1007/s00431-023-05126-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 08/16/2023]
Abstract
Evaluating, discussing, and advising on young children's lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. We aimed to develop and evaluate a new lifestyle screening tool for children aged 1-3 years. The lifestyle screening tool "FLY-Kids" was developed using data from lifestyle behaviour patterns of Dutch toddlers, age-specific lifestyle recommendations, target group analyses, and a Delphi process. Through 10 items, FLY-Kids generates a dashboard with an overview of the child's lifestyle that can be used as conversation aid. FLY-Kids was completed by parents of children aged 1-3 years attending a regular youth healthcare appointment. Youth healthcare professionals (YHCP) then used the FLY-Kids dashboard to discuss lifestyle with the parents and provided tailored advice. Parents as well as YHCP evaluated the tool after use. Descriptive and correlation statistics were used to determine the usability, feasibility, and preliminary effect of FLY-Kids. Parents (N = 201) scored an average of 3.2 (out of 9, SD 1.6) unfavourable lifestyle behaviours in their children, while 3.0% complied with all recommendations. Most unfavourable behaviours were reported in unhealthy food intake and electronic screen time behaviour. Parents and YHCP regarded FLY-Kids as usable and feasible. The number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment (r = 0.47, p < 0.001). Conclusion: FLY-Kids can be used to identify unhealthy lifestyle behaviour in young children and guide the conversation about lifestyle in preventive healthcare settings. End-users rated FLY-Kids as helpful and user-friendly. What is Known: • A healthy lifestyle is important for optimal growth, development and overall health of young children (1-3 years). • Evaluating, discussing and advising on young children's lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. What is New: • The new lifestyle screening tool FLY-Kids generates a dashboard with an overview of young children's lifestyle that can be used as conversation aid between parents and youth healthcare professionals. • As parents and youth healthcare professionals rated FLY-Kids as helpful and user-friendly, and the number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment, FLY-Kids can be considered guiding the lifestyle discussion in preventive healthcare settings.
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Affiliation(s)
- Anne Krijger
- Department of Pediatrics and Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, PO Box 2060, 3000 CB, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Liset Elstgeest
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Elly Steenbergen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Sovianne Ter Borg
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Caren Lanting
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Child Health Expertise Group, Leiden, The Netherlands
| | | | - Ondine Engelse
- Dutch Knowledge Centre for Youth Health, Utrecht, The Netherlands
| | - Angelika Kindermann
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Symone Detmar
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Child Health Expertise Group, Leiden, The Netherlands
| | - Carolien Frenkel
- Association of Dutch Infant and Dietetic Foods Industries, The Hague, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen Joosten
- Department of Pediatrics and Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, PO Box 2060, 3000 CB, Rotterdam, The Netherlands.
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Jacobo Cejudo MG, Ochoa-Rosales C, Ahmadizar F, Kavousi M, Geleijnse JM, Voortman T. The healthy beverage index is not associated with insulin resistance, prediabetes and type 2 diabetes risk in the Rotterdam Study. Eur J Nutr 2023; 62:3021-3031. [PMID: 37488428 PMCID: PMC10468439 DOI: 10.1007/s00394-023-03209-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE Whether beverage quality affects changes in glycaemic traits and type 2 diabetes (T2D) risk is unknown. We examined associations of a previously developed Healthy Beverage Index (HBI) with insulin resistance, and risk of prediabetes and T2D. METHODS We included 6769 participants (59% female, 62.0 ± 7.8 years) from the Rotterdam Study cohort free of diabetes at baseline. Diet was assessed using food-frequency questionnaires at baseline. The HBI included 10 components (energy from beverages, meeting fluid requirements, water, coffee and tea, low-fat milk, diet drinks, juices, alcohol, full-fat milk, and sugar-sweetened beverages), with a total score ranging from 0 to 100. A higher score represents a healthier beverage pattern. Data on study outcomes were available from 1993 to 2015. Multivariable linear mixed models and Cox proportional-hazards regression models were used to examine associations of the HBI (per 10 points increment) with two measurements of HOMA-IR (a proxy for insulin resistance), and risk of prediabetes and T2D. RESULTS During follow-up, we documented 1139 prediabetes and 784 T2D cases. Mean ± SD of the HBI was 66.8 ± 14.4. Higher HBI score was not associated with HOMA-IR (β: 0.003; 95% CI - 0.007, 0.014), or with risk of prediabetes (HR: 1.01; 95% CI 0.97, 1.06), or T2D (HR: 1.01; 95% CI 0.96, 1.07). CONCLUSION Our findings suggest no major role for overall beverage intake quality assessed with the HBI in insulin resistance, prediabetes and T2D incidence. The HBI may not be an adequate tool to assess beverage intake quality in our population.
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Affiliation(s)
- Maria G. Jacobo Cejudo
- Division of Human Nutrition and Health, Wageningen University, PO Box 17, 6700 AA Wageningen, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carolina Ochoa-Rosales
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Fariba Ahmadizar
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Data Science & Biostatistics, Julius Global Health, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Johanna M. Geleijnse
- Division of Human Nutrition and Health, Wageningen University, PO Box 17, 6700 AA Wageningen, The Netherlands
| | - Trudy Voortman
- Division of Human Nutrition and Health, Wageningen University, PO Box 17, 6700 AA Wageningen, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Teuwen MMH, Knaapen IRE, Vliet Vlieland TPM, Schoones JW, van den Ende CHM, van Weely SFE, Gademan MGJ. The use of PROMIS measures in clinical studies in patients with inflammatory arthritis: a systematic review. Qual Life Res 2023; 32:2731-2749. [PMID: 37103773 PMCID: PMC10474175 DOI: 10.1007/s11136-023-03422-0] [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] [Accepted: 04/11/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE Although the use of Patient-Reported Outcomes Measurement Information System (PROMIS) measures is widely advocated, little is known on their use in patients with inflammatory arthritis. We systematically describe the use and outcomes of PROMIS measures in clinical studies involving people with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA). METHODS A systematic review was conducted according to the PRISMA guidelines. Through a systematic search of nine electronic databases, clinical studies including patients with RA or axSpA and reporting the use of PROMIS measure were selected. Study characteristics, details of PROMIS measures and their outcomes, if available, were extracted. RESULTS In total, 29 studies described in 40 articles met the inclusion criteria, of which 25 studies included RA patients, three studies included axSpA patients and one study included both RA and axSpA patients. The use of two general PROMIS measures (PROMIS Global Health, PROMIS-29) and 13 different domain-specific PROMIS measures was reported, of which the PROMIS Pain Interference (n = 17), Physical Function (n = 14), Fatigue (n = 13), and Depression (n = 12) measures were most frequently used. Twenty-one studies reported their results in terms of T-scores. Most T-scores were worse than the general population mean, indicating impairments of health status. Eight studies did not report actual data but rather measurement properties of the PROMIS measures. CONCLUSION There was considerable variety regarding the different PROMIS measures used, with the PROMIS Pain interference, Physical function, Fatigue, and Depression measures being the most frequently used. In order to facilitate the comparisons across studies, more standardization of the selection of PROMIS measures is needed.
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Affiliation(s)
- M M H Teuwen
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300 RC, Leiden, The Netherlands.
| | - I R E Knaapen
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300 RC, Leiden, The Netherlands
| | - T P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300 RC, Leiden, The Netherlands
| | - J W Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, The Netherlands
| | - C H M van den Ende
- Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - S F E van Weely
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300 RC, Leiden, The Netherlands
| | - M G J Gademan
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Albinusdreef 2, P.O.Box 9600, 2300 RC, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Meijer MA, Brabers AEM, de Jong JD. Social context matters: The role of social support and social norms in support for solidarity in healthcare financing. PLoS One 2023; 18:e0291530. [PMID: 37708164 PMCID: PMC10501638 DOI: 10.1371/journal.pone.0291530] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
In many European countries, including the Netherlands, the healthcare system is financed according to the principles of solidarity. It is important, therefore, that public support for solidarity in healthcare financing is sufficient in order to ensure that people remain willing to contribute towards solidarity-based systems. The high willingness to contribute to the healthcare costs of others in the Netherlands suggests that support is generally high. However, there are differences between groups. Previous research has focused on mechanisms at the individual and institutional level to explain these differences. However, people's social context may also play a role. Little research has been conducted into this. To fill this gap, we examined the role of perceived social support and social norms in order to explain differences in the willingness to contribute to other people's healthcare costs. In November 2021, we conducted a survey study in which a questionnaire was sent to a representative sample of 1,500 members of the Dutch Healthcare Consumer Panel. This was returned by 837 panel members (56% response rate). Using logistic regression analysis, we showed that people who perceive higher levels of social support are more willing to contribute to the healthcare costs of others. We also found that the willingness to contribute is higher when someone's social context is more supportive of healthcare systems that are financed according to the principles of solidarity. This effect does not differ between people who perceive low and high levels of social support. Our results suggest that, next to the individual and institutional level, the social context of people has to be taken into consideration in policy and research addressing support for solidarity in healthcare financing.
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Affiliation(s)
- Marloes A. Meijer
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Anne E. M. Brabers
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Judith D. de Jong
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Hiep MAJ, Heerink WJ, Groen HC, Ruers TJM. Feasibility of tracked ultrasound registration for pelvic-abdominal tumor navigation: a patient study. Int J Comput Assist Radiol Surg 2023; 18:1725-1734. [PMID: 37227572 DOI: 10.1007/s11548-023-02937-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/24/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE Surgical navigation techniques can guide surgeons in localizing pelvic-abdominal malignancies. For abdominal navigation, accurate patient registration is crucial and is generally performed using an intra-operative cone-beam CT (CBCT). However, this method causes 15-min surgical preparation workflow interruption and radiation exposure, and more importantly, it cannot be repeated during surgery to compensate for large patient movement. As an alternative, the accuracy and feasibility of tracked ultrasound (US) registration are assessed in this patient study. METHODS Patients scheduled for surgical navigation during laparotomy of pelvic-abdominal malignancies were prospectively included. In the operating room, two percutaneous tracked US scans of the pelvic bone were acquired: one in supine and one in Trendelenburg patient position. Postoperatively, the bone surface was semiautomatically segmented from US images and registered to the bone surface on the preoperative CT scan. The US registration accuracy was computed using the CBCT registration as a reference and acquisition times were compared. Additionally, both US measurements were compared to quantify the registration error caused by patient movement into Trendelenburg. RESULTS In total, 18 patients were included and analyzed. US registration resulted in a mean surface registration error of 1.2 ± 0.2 mm and a mean target registration error of 3.3 ± 1.4 mm. US acquisitions were 4 × faster than the CBCT scans (two-sample t-test P < 0.05) and could even be performed during standard patient preparation before skin incision. Patient repositioning in Trendelenburg caused a mean target registration error of 7.7 ± 3.3 mm, mainly in cranial direction. CONCLUSION US registration based on the pelvic bone is accurate, fast and feasible for surgical navigation. Further optimization of the bone segmentation algorithm will allow for real-time registration in the clinical workflow. In the end, this would allow intra-operative US registration to correct for large patient movement. TRIAL REGISTRATION This study is registered in ClinicalTrials.gov (NCT05637359).
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Affiliation(s)
- M A J Hiep
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands.
| | - W J Heerink
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
| | - H C Groen
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
| | - T J M Ruers
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
- Faculty of Science and Technology (TNW), Nanobiophysics Group (NBP), University of Twente, 7500 AE, Enschede, The Netherlands
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Molenaar JM, Boesveld IC, Struijs JN, Kiefte-de Jong JC. The Dutch Solid Start program: describing the implementation and experiences of the program's first thousand days. BMC Health Serv Res 2023; 23:926. [PMID: 37649017 PMCID: PMC10470180 DOI: 10.1186/s12913-023-09873-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/03/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND In 2018, the Dutch government initiated the Solid Start program to provide each child the best start in life. The program focuses on the crucial first thousand days of life, which span from preconception to a child's second birthday, and has a specific focus towards (future) parents and young children in vulnerable situations. A key program element is improving collaboration between the medical and social sector by creating Solid Start coalitions. This study aimed to describe the implementation of the Dutch Solid Start program, in order to learn for future practice and policy. Specifically, this paper describes to what extent Solid Start is implemented within municipalities and outlines stakeholders' experiences with the implementation of Solid Start and the associated cross-sectoral collaboration. METHODS Quantitative and qualitative data were collected from 2019 until 2021. Questionnaires were sent to all 352 Dutch municipalities and analyzed using descriptive statistics. Qualitative data were obtained through focus group discussions(n = 6) and semi-structured interviews(n = 19) with representatives of care and support organizations, knowledge institutes and professional associations, Solid Start project leaders, advisors, municipal officials, researchers, clients and experts-by-experience. Qualitative data were analyzed using the Rainbow Model of Integrated Care. RESULTS Findings indicated progress in the development of Solid Start coalitions(n = 40 in 2019, n = 140 in 2021), and an increase in cross-sectoral collaboration. According to the stakeholders, initiating Solid Start increased the sense of urgency concerning the importance of the first thousand days and stimulated professionals from various backgrounds to get to know each other, resulting in more collaborative agreements on cross-sectoral care provision. Important elements mentioned for effective collaboration within coalitions were an active coordinator as driving force, and a shared societal goal. However, stakeholders experienced that Solid Start is not yet fully incorporated into all professionals' everyday practice. Most common barriers for collaboration related to systemic integration at macro-level, including limited resources and collaboration-inhibiting regulations. Stakeholders emphasized the importance of ensuring Solid Start and mentioned various needs, including sustainable funding, supportive regulations, responsiveness to stakeholders' needs, ongoing knowledge development, and client involvement. CONCLUSION Solid Start, as a national program with strong local focus, has led to various incremental changes that supported cross-sectoral collaboration to improve care during the first thousand days, without major transformations of systemic structures. However, to ensure the program's sustainability, needs such as sustainable funding should be addressed.
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Affiliation(s)
- Joyce M Molenaar
- Department of Quality of Care and Health Economics, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), 3721, MA, Bilthoven, the Netherlands.
- Department of Public Health and Primary Care/ Health Campus The Hague, Leiden University Medical Centre, 2511, DP, The Hague, the Netherlands.
| | - Inge C Boesveld
- Department of Quality of Care and Health Economics, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), 3721, MA, Bilthoven, the Netherlands
| | - Jeroen N Struijs
- Department of Quality of Care and Health Economics, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), 3721, MA, Bilthoven, the Netherlands
- Department of Public Health and Primary Care/ Health Campus The Hague, Leiden University Medical Centre, 2511, DP, The Hague, the Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Public Health and Primary Care/ Health Campus The Hague, Leiden University Medical Centre, 2511, DP, The Hague, the Netherlands
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Ohm M, van Straalen JW, de Joode-Smink G, van Montfrans J, Bartels M, van Wildenbeest JG, Lindemans CA, Wennink RA, de Boer JH, Sanders EA, Verduyn-Lunel FM, Berbers GA, Wulffraat NM, Jansen MHA. Meningococcal ACWY conjugate vaccine immunogenicity in adolescents with primary or secondary immune deficiencies, a prospective observational cohort study. Pediatr Rheumatol Online J 2023; 21:73. [PMID: 37475057 PMCID: PMC10360259 DOI: 10.1186/s12969-023-00846-3] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/16/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Immunization with meningococcal ACWY conjugate vaccine induces protective antibodies against invasive meningococcal disease (IMD) caused by serogroups A, C, W and Y. We studied MenACWY-TT vaccine immunogenicity in adolescents with a heterogenous group of primary and secondary immune deficiency including patients with systemic lupus erythematosus, mixed connective tissue disease, vasculitis, uveitis, 22Q11 syndrome, sickle cell disease, and patients who underwent stem cell transplantation for bone marrow failure. FINDINGS We enrolled 69 individuals aged 14-18 years diagnosed with a primary or secondary immune deficiency in a prospective observational cohort study. All patients received a single dose of MenACWY-TT vaccine during the catch-up campaign 2018-19 because of the IMD-W outbreak in the Netherlands. Capsular polysaccharide-specific (PS) IgG concentrations against MenACWY were measured before and 3-6, 12, and 24 months after vaccination. Overall, geometric mean concentrations (GMCs) of MenACWY-PS-specific IgG were lower in patients compared to data from healthy, aged-matched controls (n = 75) reaching significance at 12 months postvaccination for serogroup A and W (adjusted GMC ratios 0.26 [95% CI: 0.15-0.47] and 0.22 [95% CI: 0.10-0.49], respectively). No serious adverse events were reported by study participants. CONCLUSIONS The MenACWY conjugate vaccine was less immunogenic in adolescent patients with primary or secondary immunodeficiency compared to healthy controls, urging the need for further surveillance of these patients and supporting considerations for booster MenACWY conjugate vaccinations in these patient groups.
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Affiliation(s)
- Milou Ohm
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joeri W van Straalen
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Gerrie de Joode-Smink
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Joris van Montfrans
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
- Department of Pediatric Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Marije Bartels
- Department of Pediatric Hematology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Joanne G van Wildenbeest
- Department of Pediatric Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Caroline A Lindemans
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Roos Aw Wennink
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Joke H de Boer
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Elisabeth Am Sanders
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Frans M Verduyn-Lunel
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Guy Am Berbers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Nico M Wulffraat
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Marc H A Jansen
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Brouwers M, Broekharst DSE, de Boer B, Groen WG, Verbeek H. An overview of innovative living arrangements within long-term care and their characteristics: a scoping review. BMC Geriatr 2023; 23:442. [PMID: 37464287 PMCID: PMC10355008 DOI: 10.1186/s12877-023-04158-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/06/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Within long-term care, a culture change (e.g. focus on increasing autonomy in everyday life) is leading to the development of innovative living arrangements for older adults. Insight into characteristics of innovative living arrangements, which are described as an alternative to regular nursing homes, is lacking. This review aims to provide an overview of innovative living arrangements and to describe their defining characteristics. METHODS A scoping review was performed following the framework of Arksey and O'Malley. The preferred reporting items for systematic reviews and meta-analyses with extension, for scoping reviews (PRISMA-ScR) was also followed. The databases PubMed, PsycInfo, CINAHL, and Web of Science were searched. Articles, published between 2012 and 2023 were included when they presented an innovative living arrangement as an alternative to regular nursing homes. A thematic analysis was performed, describing the physical, social, and organizational environment of the innovative living arrangements. RESULTS Fifty-six articles were identified describing seven types of distinct innovative living arrangements: small-scale living, the green house model, shared housing arrangements, green care farms, dementia villages, group homes, intergenerational living, and an 'other' category. The themes included supporting autonomy and creating a small-scale and/or homelike environment, which were emphasized in most innovative living arrangements. Other themes, such as involvement of the community, focus on nature, integration of work tasks, and involvement of family members, were emphasized in a subsection of the described living arrangements. Twenty-eight articles reported on the effects of the innovative living environment on residents, family members, or staff members. Most articles (N = 22) studied resident-related outcomes, focusing mainly on quality of life and aspects of daily life. CONCLUSION More insight into the mechanisms of the social and organizational environments is needed, which may lead to greater transparency and homogeneity regarding the description of living arrangements. This review shows that more knowledge is needed about the potential key elements of innovative living arrangements, especially related to their social and organizational environment. This may provide a better guide for developers within long-term care.
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Affiliation(s)
- Mara Brouwers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. BOX 616, Maastricht, 6200 MD, the Netherlands.
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands.
| | - Damien S E Broekharst
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
- University Network for the care sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Bram de Boer
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. BOX 616, Maastricht, 6200 MD, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Wim G Groen
- Department of Medicine for Older People, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. BOX 616, Maastricht, 6200 MD, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
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Ruigrok TJH, Mantel SA, Orlandini L, de Knegt C, Vincent AJPE, Spoor JKH. Sympathetic components in left and right human cervical vagus nerve: implications for vagus nerve stimulation. Front Neuroanat 2023; 17:1205660. [PMID: 37492698 PMCID: PMC10364449 DOI: 10.3389/fnana.2023.1205660] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/20/2023] [Indexed: 07/27/2023] Open
Abstract
Cervical vagus nerve stimulation is in a great variety of clinical situations indicated as a form of treatment. It is textbook knowledge that at the cervical level the vagus nerve contains many different fiber classes. Yet, recently, several reports have shown that this nerve also may contain an additional class of potentially noradrenergic fibers, suggested to denote efferent sympathetic fibers. As such, the nature and presence of these fibers should be considered when choosing a stimulation protocol. We have studied human vagus material extracted from dissection room cadavers in order to further confirm the presence of this class of fibers, to study their origin and direction within the nerve and to determine their distribution and variability between subjects and pairs of left and right nerves of the same individual. Sections were studied with immunohistochemical techniques using antibodies against tyrosine hydroxylase (TH: presumed to indicate noradrenergic fibers), myelin basic protein and neurofilament. Our results show that at least part of the TH-positive fibers derive from the superior cervical ganglion or sympathetic trunk, do not follow a cranial but take a peripheral course through the nerve. The portion of TH-positive fibers is highly variable between individuals but also between the left and right pairs of the same individual. TH-positive fibers can distribute and wander throughout the fascicles but maintain a generally clustered appearance. The fraction of TH-positive fibers generally diminishes in the left cervical vagus nerve when moving in a caudal direction but remains more constant in the right nerve. These results may help to determine optimal stimulation parameters for cervical vagus stimulation in clinical settings.
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Affiliation(s)
- Tom J. H. Ruigrok
- Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sophia A. Mantel
- Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Neurosurgery, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Lara Orlandini
- Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Neurosurgery, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Corné de Knegt
- Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Neurosurgery, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | | | - Jochem K. H. Spoor
- Department of Neurosurgery, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Urlings JHJ, Backhaus R, Verbeek H, de Boer B, Koopmans RTCM, Gerritsen DL, Hamers JPH. After COVID-19 vaccinations: what does living and working in nursing homes look like? BMC Geriatr 2023; 23:298. [PMID: 37193994 PMCID: PMC10186323 DOI: 10.1186/s12877-023-03987-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 04/21/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Nursing homes were disproportionally affected by the COVID-19 pandemic. Vaccination was considered critical for the normalization of daily live of nursing home residents. The present study investigates the impact of the prolonged COVID-19 pandemic and the effect of vaccinations on the daily lives of residents and staff in Dutch nursing homes. SETTING AND PARTICIPANTS The sample consisted of 78 nursing homes that participated in the Dutch national pilot on nursing home visits after the COVID-19 pandemic. One contact person per nursing home was approached for participation in this mixed-methods cross-sectional study. METHODS Data was collected twice through questionnaires in April and December 2021. Quantitative questions focused on recent COVID-19 outbreaks, progress of vaccination, effects of vaccination on daily living in the nursing home and burden experienced by staff. Open-ended questions addressed the prolonged effect of the pandemic on residents, family members and staff. RESULTS The overall vaccination rate of residents across nursing homes appeared to be high among both residents and staff. However, daily living in the nursing home had not returned to normal concerning personal interactions, visits, the use of facilities and work pressure. Nursing homes continued to report a negative impact of the pandemic on residents, family members and staff. CONCLUSIONS Restrictions to the daily lives of residents in nursing homes were stricter than restrictions imposed on society as a whole. Returning to a normal daily living and working was found to be complex for nursing homes. With the emergence of new variants of the virus, policies strongly focusing on risk aversion were predominantly present in nursing homes.
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Affiliation(s)
- Judith H J Urlings
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands.
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands.
| | - Ramona Backhaus
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Bram de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- De Waalboog "Joachim en Anna", Center for Specialized Geriatric Care, Nijmegen, the Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan P H Hamers
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
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Naber J, Reijmer Y, van den Berg B. [Quality improvement as a joint task]. TSG 2023; 101:58-62. [PMID: 37206642 PMCID: PMC10157124 DOI: 10.1007/s12508-023-00390-1] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/21/2023]
Abstract
This article presents the key elements of the quality measure included in the Dignity and Pride program of the Dutch Ministry of Health, Welfare and Sport in cooperation with Vilans, the national centre of expertise for long-term care in the Netherlands. Nursing homes take part in the quality measure at the start of the program to investigate where they stand with respect to the nursing home quality framework.
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Affiliation(s)
- Juultje Naber
- Vilans, landelijke kennisorganisatie voor zorg en ondersteuning, Utrecht, Nederland
| | - Yael Reijmer
- Vilans, landelijke kennisorganisatie voor zorg en ondersteuning, Utrecht, Nederland
| | - Bellis van den Berg
- Vilans, landelijke kennisorganisatie voor zorg en ondersteuning, Utrecht, Nederland
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Janssen SHM, Vlooswijk C, Manten-Horst E, Sleeman SHE, Bijlsma RM, Kaal SEJ, Kerst JM, Tromp JM, Bos MEMM, van der Hulle T, Lalisang RI, Nuver J, Kouwenhoven MCM, van der Graaf WTA, Husson O. Learning from long-term adolescent and young adult (AYA) cancer survivors regarding their age-specific care needs to improve current AYA care programs. Cancer Med 2023. [PMID: 37119039 DOI: 10.1002/cam4.6001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/29/2023] [Accepted: 04/14/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Despite growing (inter)national awareness and appreciation, age-specific care is still not always self-evident and accepted as standard of care for adolescent and young adult (AYA) cancer patients. It is unknown whether long-term AYA cancer survivors have missed age-specific care, and if so, which survivors missed it and regarding which topics. METHODS The Netherlands Cancer Registry (NCR) identified all long-term AYA cancer survivors (aged 18-39 years at initial cancer diagnosis, 5-20 years past diagnosis) in the Netherlands, who were invited to participate in a population-based, observational, cross-sectional questionnaire study (SURVAYA study), including questions on care needs. RESULTS In total, 3.989 AYAs participated (35.3% response rate). One-third of them had a need for age-specific care (33.5%), 41.2% had no need and 25.3% did not know whether they had a need. Those who had a need for age-specific care were significantly more often female, higher educated, diagnosed at a younger age, and treated with chemotherapy, radiotherapy or hormone therapy. Most frequent topics were disease and treatment (29.7%), emotions (24.1%), friends (22.6%), family and children (15.6%), fertility and pregnancy (14.8%), work and reintegration (10.5%), care not tailored (13.8%), and overarching care and life (27.7%). Palliative care (0.0%), spirituality (0.2%), death (0.7%), complementary care (0.7%), and late effects (1.3%) were mentioned least. CONCLUSIONS A substantial proportion of long-term AYA cancer survivors showed a need for age-specific care, varying by sociodemographic and clinical factors, on a wide variety of topics, which could be targeted to improve current AYA care services.
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Affiliation(s)
- Silvie H M Janssen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Carla Vlooswijk
- Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | | | | | - Rhodé M Bijlsma
- Department of Medical Oncology, University Medical Center, Utrecht, The Netherlands
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Martijn Kerst
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Jacqueline M Tromp
- Department of Medical Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Monique E M M Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tom van der Hulle
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Roy I Lalisang
- Department of Internal Medicine, GROW-School of Oncology and Reproduction, Maastricht UMC+ Comprehensive Cancer Center, Maastricht, The Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Mathilde C M Kouwenhoven
- Department of Neurology, Amsterdam UMC, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Sobiecki JG, Imamura F, Davis CR, Sharp SJ, Koulman A, Hodgson JM, Guevara M, Schulze MB, Zheng JS, Agnoli C, Bonet C, Colorado-Yohar SM, Fagherazzi G, Franks PW, Gundersen TE, Jannasch F, Kaaks R, Katzke V, Molina-Montes E, Nilsson PM, Palli D, Panico S, Papier K, Rolandsson O, Sacerdote C, Tjønneland A, Tong TYN, van der Schouw YT, Danesh J, Butterworth AS, Riboli E, Murphy KJ, Wareham NJ, Forouhi NG. A nutritional biomarker score of the Mediterranean diet and incident type 2 diabetes: Integrated analysis of data from the MedLey randomised controlled trial and the EPIC-InterAct case-cohort study. PLoS Med 2023; 20:e1004221. [PMID: 37104291 PMCID: PMC10138823 DOI: 10.1371/journal.pmed.1004221] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/15/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Self-reported adherence to the Mediterranean diet has been modestly inversely associated with incidence of type 2 diabetes (T2D) in cohort studies. There is uncertainty about the validity and magnitude of this association due to subjective reporting of diet. The association has not been evaluated using an objectively measured biomarker of the Mediterranean diet. METHODS AND FINDINGS We derived a biomarker score based on 5 circulating carotenoids and 24 fatty acids that discriminated between the Mediterranean or habitual diet arms of a parallel design, 6-month partial-feeding randomised controlled trial (RCT) conducted between 2013 and 2014, the MedLey trial (128 participants out of 166 randomised). We applied this biomarker score in an observational study, the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study, to assess the association of the score with T2D incidence over an average of 9.7 years of follow-up since the baseline (1991 to 1998). We included 22,202 participants, of whom 9,453 were T2D cases, with relevant biomarkers from an original case-cohort of 27,779 participants sampled from a cohort of 340,234 people. As a secondary measure of the Mediterranean diet, we used a score estimated from dietary-self report. Within the trial, the biomarker score discriminated well between the 2 arms; the cross-validated C-statistic was 0.88 (95% confidence interval (CI) 0.82 to 0.94). The score was inversely associated with incident T2D in EPIC-InterAct: the hazard ratio (HR) per standard deviation of the score was 0.71 (95% CI: 0.65 to 0.77) following adjustment for sociodemographic, lifestyle and medical factors, and adiposity. In comparison, the HR per standard deviation of the self-reported Mediterranean diet was 0.90 (95% CI: 0.86 to 0.95). Assuming the score was causally associated with T2D, higher adherence to the Mediterranean diet in Western European adults by 10 percentiles of the score was estimated to reduce the incidence of T2D by 11% (95% CI: 7% to 14%). The study limitations included potential measurement error in nutritional biomarkers, unclear specificity of the biomarker score to the Mediterranean diet, and possible residual confounding. CONCLUSIONS These findings suggest that objectively assessed adherence to the Mediterranean diet is associated with lower risk of T2D and that even modestly higher adherence may have the potential to reduce the population burden of T2D meaningfully. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000602729 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363860.
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Affiliation(s)
- Jakub G. Sobiecki
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Courtney R. Davis
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Stephen J. Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Albert Koulman
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Nutritional Biomarker Laboratory, National Institute for Health Research Biomedical Research Centre, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jonathan M. Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Marcela Guevara
- Navarra Public Health Institute, Pamplona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Ju-Sheng Zheng
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Key Laboratory of Growth Regulation and Translation Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, L’Hospitalet de Llobregat, Barcelona, Spain
- Nutrition and Cancer Group, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Sandra M. Colorado-Yohar
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Insitute of Health, Strassen, Luxembourg
- Center of Epidemiology and Population Health UMR 1018, Inserm, Paris South—Paris Saclay University, Gustave Roussy Institute, Villejuif, France
| | - Paul W. Franks
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Esther Molina-Montes
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Nutrition and Food Technology (INYTA) ‘José Mataix’, Biomedical Research Centre, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Nutrition and Food Science, University of Granada, Granada, Spain
| | | | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network—ISPRO, Florence, Italy
| | - Salvatore Panico
- Department of Mental, Physical Health and Preventive Medicine, University “L. Vanvitelli”, Naples, Italy
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tammy Y. N. Tong
- Department of Mental, Physical Health and Preventive Medicine, University “L. Vanvitelli”, Naples, Italy
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - John Danesh
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- British Heart Foundation Cambridge Centre of Excellence, Division of Cardiovascular Medicine, Addenbrooke’s Hospital, Cambridge, United Kingdom
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
- Health Data Research UK Cambridge, University of Cambridge, Cambridge, United Kingdom
| | - Adam S. Butterworth
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Elio Riboli
- School of Public Health, Imperial College London, London, United Kingdom
| | - Karen J. Murphy
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Nita G. Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
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Elzinga E, de Beurs DP, Beekman ATF, Maarsingh OR, Gilissen R. Nudging General Practitioners to explore suicidal thoughts among depressed patients. BMC Prim Care 2023; 24:88. [PMID: 37005569 PMCID: PMC10067310 DOI: 10.1186/s12875-023-02043-3] [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] [Grants] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/22/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND While frank discussion of suicidal thoughts in patients with depression is important for the prevention of suicide, suicide exploration of General Practitioners (GPs) is suboptimal. This study aimed to assess whether an intervention that prompts pop-up screens nudges GPs to more frequently explore suicidal thoughts over the course of two years. METHODS From January 2017 to December 2018, the intervention was incorporated in the information system of the Dutch general practice sentinel network. New registration of an episode of depression triggered a pop-up screen referring to a questionnaire about GPs' behaviour with regard to exploring suicidal thoughts. In two years, 625 questionnaires were completed by GPs and analysed using multilevel logistic regression analyses. RESULTS Compared to the first year, GPs were 50% more likely to explore suicidal thoughts among patients in the second year (OR 1.48; 95%CI 1.01-2.16). When adjusting for patients' gender and age we found that the effect of the pop-up screens disappeared (OR 1.33; 95% CI 0.90-1.97). Suicide exploration occurred less frequently in women than in men (OR 0.64; 95% CI 0.43-0.98) and in older compared to younger patients (OR 0.97; 95% CI 0.96-0.98 per year older). In addition, 26% of variation in suicide exploration was because of differences in general practice. There was no evidence that general practices developed differently over time. CONCLUSIONS Although low cost and easy to administer, the pop-up system was not effective in nudging GPs to explore suicidality more frequently. We encourage studies to test whether implementing these nudges as part of a multifaceted approach will lead to a stronger effect. Moreover, we recommend researchers to include more variables, such as work experience or previous mental health training, to better understand the effects of the intervention on GPs' behaviour.
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Affiliation(s)
- Elke Elzinga
- 113 Suicide prevention, research department, Paasheuvelweg 25, Amsterdam, 1105 BP, the Netherlands.
- Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
| | - Derek P de Beurs
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Research & Innovation, GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Otto R Maarsingh
- Department of General Practice, Amsterdam UMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Renske Gilissen
- 113 Suicide prevention, research department, Paasheuvelweg 25, Amsterdam, 1105 BP, the Netherlands
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van Os J, Pries LK, ten Have M, de Graaf R, van Dorsselaer S, Bak M, Kenis G, Lin BD, Gunther N, Luykx JJ, Rutten BPF, Guloksuz S. Context v. algorithm: evidence that a transdiagnostic framework of contextual clinical characterization is of more clinical value than categorical diagnosis. Psychol Med 2023; 53:1825-1833. [PMID: 37310330 PMCID: PMC10106290 DOI: 10.1017/s0033291721003445] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND A transdiagnostic and contextual framework of 'clinical characterization', combining clinical, psychopathological, sociodemographic, etiological, and other personal contextual data, may add clinical value over and above categorical algorithm-based diagnosis. METHODS Prediction of need for care and health care outcomes was examined prospectively as a function of the contextual clinical characterization diagnostic framework in a prospective general population cohort (n = 6646 at baseline), interviewed four times between 2007 and 2018 (NEMESIS-2). Measures of need, service use, and use of medication were predicted as a function of any of 13 DSM-IV diagnoses, both separately and in combination with clinical characterization across multiple domains: social circumstances/demographics, symptom dimensions, physical health, clinical/etiological factors, staging, and polygenic risk scores (PRS). Effect sizes were expressed as population attributable fractions. RESULTS Any prediction of DSM-diagnosis in relation to need and outcome in separate models was entirely reducible to components of contextual clinical characterization in joint models, particularly the component of transdiagnostic symptom dimensions (a simple score of the number of anxiety, depression, mania, and psychosis symptoms) and staging (subthreshold, incidence, persistence), and to a lesser degree clinical factors (early adversity, family history, suicidality, slowness at interview, neuroticism, and extraversion), and sociodemographic factors. Clinical characterization components in combination predicted more than any component in isolation. PRS did not meaningfully contribute to any clinical characterization model. CONCLUSION A transdiagnostic framework of contextual clinical characterization is of more value to patients than a categorical system of algorithmic ordering of psychopathology.
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Affiliation(s)
- Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lotta-Katrin Pries
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Margreet ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Maarten Bak
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- FACT, Mondriaan Mental Health, Maastricht, The Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Bochao D. Lin
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nicole Gunther
- School of Psychology, Open University, Heerlen, The Netherlands
| | - Jurjen J. Luykx
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- GGNet Mental Health, Apeldoorn, The Netherlands
| | - Bart P. F. Rutten
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Florian S, Ichou M, Panico L, Pinel-Jacquemin S, Vrijkotte TGM, Harskamp-van Ginkel MW, Huang RC, Carson J, Rodriguez LSM, Subiza-Pérez M, Vrijheid M, Fernández-Barrés S, Yang TC, Wright J, Corpeleijn E, Cardol M, Isaevska E, Moccia C, Kooijman MN, Voerman E, Jaddoe V, Welten M, Spada E, Rebagliato M, Beneito A, Ronfani L, Charles MA. Differences in birth weight between immigrants' and natives' children in Europe and Australia: a LifeCycle comparative observational cohort study. BMJ Open 2023; 13:e060932. [PMID: 36958776 PMCID: PMC10040079 DOI: 10.1136/bmjopen-2022-060932] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE Research on adults has identified an immigrant health advantage, known as the 'immigrant health paradox', by which migrants exhibit better health outcomes than natives. Is this health advantage transferred from parents to children in the form of higher birth weight relative to children of natives? SETTING Western Europe and Australia. PARTICIPANTS We use data from nine birth cohorts participating in the LifeCycle Project, including five studies with large samples of immigrants' children: Etude Longitudinale Française depuis l'Enfance-France (N=12 494), the Raine Study-Australia (N=2283), Born in Bradford-UK (N=4132), Amsterdam Born Children and their Development study-Netherlands (N=4030) and the Generation R study-Netherlands (N=4877). We include male and female babies born to immigrant and native parents. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome is birth weight measured in grams. Different specifications were tested: birth weight as a continuous variable including all births (DV1), the same variable but excluding babies born with over 4500 g (DV2), low birth weight as a 0-1 binary variable (1=birth weight below 2500 g) (DV3). Results using these three measures were similar, only results using DV1 are presented. Parental migration status is measured in four categories: both parents natives, both born abroad, only mother born abroad and only father born abroad. RESULTS Two patterns in children's birth weight by parental migration status emerged: higher birth weight among children of immigrants in France (+12 g, p<0.10) and Australia (+40 g, p<0.10) and lower birth weight among children of immigrants in the UK (-82 g, p<0.05) and the Netherlands (-80 g and -73 g, p<0.001) compared with natives' children. Smoking during pregnancy emerged as a mechanism explaining some of the birth weight gaps between children of immigrants and natives. CONCLUSION The immigrant health advantage is not universally transferred to children in the form of higher birth weight in all host countries. Further research should investigate whether this cross-national variation is due to differences in immigrant communities, social and healthcare contexts across host countries.
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Affiliation(s)
- Sandra Florian
- French National Institute for Demographic Studies, INED, Paris, France
| | - Mathieu Ichou
- French National Institute for Demographic Studies, INED, Paris, France
| | - Lidia Panico
- French National Institute for Demographic Studies, INED, Paris, France
- Centre for Research on Social Inequalities (CRIS), Sciences Po, Paris, France
| | | | - Tanja G M Vrijkotte
- Department of Public Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Margreet W Harskamp-van Ginkel
- Department of Public Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Rae-Chi Huang
- Nutrition and Health Innovation Research Institute, Edith Cowan University School of Medical and Health Sciences, Perth, Western Australia, Australia
| | - Jennie Carson
- Telethon Kids Institute, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Loreto Santa Marina Rodriguez
- Sub Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, San Sebastián, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Mikel Subiza-Pérez
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastián, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- ISGlobal, Barcelona, Spain
| | | | - Tiffany C Yang
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Institute for Health Research, Bradford, UK
| | - John Wright
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Institute for Health Research, Bradford, UK
| | - Eva Corpeleijn
- Department of Epidemiology, GECKO Drenthe Cohort, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marloes Cardol
- Department of Epidemiology, GECKO Drenthe Cohort, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elena Isaevska
- Dipartimento di Scienze Mediche, Universita degli Studi di Torino, Torino, Italy
| | - Chiara Moccia
- Department of Medical Sciences, University of Turin, Torino, Italy
| | - Marjolein N Kooijman
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Ellis Voerman
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Vincent Jaddoe
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Marieke Welten
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Elena Spada
- Unit of Epidemiology, Meyer Children's University Hospital, Florence, Italy
| | - Marisa Rebagliato
- Predepartamental Unit of Medicine, Universitat Jaume I, Castello de la Plana, Comunitat Valenciana, Spain
- CIBERESP, Madrid, Spain
| | - Andrea Beneito
- Joint Research Unit in Epidemiology, Environment and Health, FISABIO, Valencia, Spain
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Istituto di Ricovero e Cura a Carattere Scientifico materno infantile Burlo Garofolo, Trieste, Italy
| | - Marie-Aline Charles
- Inserm and INED Joint Research Group, Paris, France
- Université Paris Cité, Inserm, Inrae, Cress, Paris, France
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Prins HAB, Crespo R, Lungu C, Rao S, Li L, Overmars RJ, Papageorgiou G, Mueller YM, Stoszko M, Hossain T, Kan TW, Rijnders BJA, Bax HI, van Gorp ECM, Nouwen JL, de Vries-Sluijs TEMS, Schurink CAM, de Mendonça Melo M, van Nood E, Colbers A, Burger D, Palstra RJ, van Kampen JJA, van de Vijver DAMC, Mesplède T, Katsikis PD, Gruters RA, Koch BCP, Verbon A, Mahmoudi T, Rokx C. The BAF complex inhibitor pyrimethamine reverses HIV-1 latency in people with HIV-1 on antiretroviral therapy. Sci Adv 2023; 9:eade6675. [PMID: 36921041 PMCID: PMC10017042 DOI: 10.1126/sciadv.ade6675] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Reactivation of the latent HIV-1 reservoir is a first step toward triggering reservoir decay. Here, we investigated the impact of the BAF complex inhibitor pyrimethamine on the reservoir of people living with HIV-1 (PLWH). Twenty-eight PLWH on suppressive antiretroviral therapy were randomized (1:1:1:1 ratio) to receive pyrimethamine, valproic acid, both, or no intervention for 14 days. The primary end point was change in cell-associated unspliced (CA US) HIV-1 RNA at days 0 and 14. We observed a rapid, modest, and significant increase in (CA US) HIV-1 RNA in response to pyrimethamine exposure, which persisted throughout treatment and follow-up. Valproic acid treatment alone did not increase (CA US) HIV-1 RNA or augment the effect of pyrimethamine. Pyrimethamine treatment did not result in a reduction in the size of the inducible reservoir. These data demonstrate that the licensed drug pyrimethamine can be repurposed as a BAF complex inhibitor to reverse HIV-1 latency in vivo in PLWH, substantiating its potential advancement in clinical studies.
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Affiliation(s)
- Henrieke A. B. Prins
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Raquel Crespo
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Cynthia Lungu
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Shringar Rao
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Letao Li
- Department of Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ronald J. Overmars
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Yvonne M. Mueller
- Department of Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Mateusz Stoszko
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Tanvir Hossain
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Tsung Wai Kan
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bart J. A. Rijnders
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Hannelore I. Bax
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Eric C. M. van Gorp
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jan L. Nouwen
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Theodora E. M. S. de Vries-Sluijs
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Carolina A. M. Schurink
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Mariana de Mendonça Melo
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Els van Nood
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Angela Colbers
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands
| | - David Burger
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands
| | - Robert-Jan Palstra
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | | - Thibault Mesplède
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Peter D. Katsikis
- Department of Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Rob A. Gruters
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Birgit C. P. Koch
- Department of Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Annelies Verbon
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Internal Medicine, University Medical Center, Utrecht, Netherlands
| | - Tokameh Mahmoudi
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Casper Rokx
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
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de Haan M, van Eijk-Hustings Y, Bessems-Beks M, De Bruijn-Geraets D, Dirksen C, Vrijhoef H. Evaluating task shifting to the clinical technologist in Dutch healthcare: A mixed methods study. PLoS One 2023; 18:e0281053. [PMID: 36857391 PMCID: PMC9976997 DOI: 10.1371/journal.pone.0281053] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/16/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Expected rise in the demand for healthcare and a dropping supply of healthcare professionals, has generated an increased interest in the most effective deployment of healthcare professionals. Consequently, task shifting has become a common strategy to redistribute tasks between established professional groups, however, little is known about the effects of shifting tasks to emerging professional groups. The aim of this study was to evaluate a legal amendment to facilitate task shifting to an emerging profession in Dutch healthcare: Clinical Technologists (CTs). CTs were introduced and provided an Extended Scope of Practice (ESP) to perform nine 'reserved procedures' independently. METHODS A concurrent multi-phase mixed methods study was used to evaluate whether a legal amendment to facilitate task shifting to CTs was effective and efficient. RESULTS The results show that CTs use their ESP frequently to perform five categories of reserved procedures independently and suggest that the ESP increased the efficiency of care delivery for those procedures. Additionally, the findings highlight that task shifting was influenced by the setting in which CTs worked, time allotted to patient-contact as well as external factors (e.g., financing). CONCLUSIONS This study provides tentative lessons for policymakers on how task shifting to emerging professional groups can be improved. Providing a legal amendment to facilitate task shifting to CTs seems to be effective and efficient. However, it also poses multiple challenges. While established professional groups can face similar challenges, it is likely that these are exacerbated for emerging professional groups, particularly when shifting tasks occurs horizontally.
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Affiliation(s)
- Maarten de Haan
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, Maastricht, The Netherlands
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
- National Healthcare Institute (Zorginstituut Nederland), Diemen, The Netherlands
- * E-mail:
| | - Yvonne van Eijk-Hustings
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, Maastricht, The Netherlands
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Monique Bessems-Beks
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, Maastricht, The Netherlands
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Daisy De Bruijn-Geraets
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, Maastricht, The Netherlands
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Carmen Dirksen
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, Maastricht, The Netherlands
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Clinical Trial Center Maastricht (CTCM), Maastricht, The Netherlands
| | - Hubertus Vrijhoef
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, Maastricht, The Netherlands
- Panaxea b.v., Amsterdam, The Netherlands
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49
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de Feijter M, Kocevska D, Ikram MA, Luik AI. The bidirectional association of 24-h activity rhythms and sleep with depressive symptoms in middle-aged and elderly persons. Psychol Med 2023; 53:1418-1425. [PMID: 37010217 PMCID: PMC10009400 DOI: 10.1017/s003329172100297x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/29/2021] [Accepted: 07/06/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND In older populations disturbed 24-h activity rhythms, poor sleep, and depressive symptoms are often lingering and co-morbid, making treatment difficult. To improve insights into these commonly co-occurring problems, we assessed the bidirectional association of sleep and 24-h activity rhythms with depressive symptoms in middle-aged and elderly persons. METHODS In 1734 participants (mean age: 62.3 ± 9.3 years, 55% women) from the prospective Rotterdam Study, 24-h activity rhythms and sleep were estimated with actigraphy (mean duration: 146 ± 19.6 h), sleep quality with the Pittsburgh Sleep Quality Index, and depressive symptoms with the Center for Epidemiological Studies Depression scale. Repeated measures were available for 947 participants (54%) over a median follow-up of 6 years (interquartile range = 5.6-6.3). Linear-mixed models were used to assess temporal associations of 24-h activity rhythms and sleep with depressive symptoms in both directions. RESULTS High 24-h activity rhythm fragmentation (IV) (B = 1.002, 95% confidence interval (CI) = 0.641-1.363), long time in bed (TIB) (B = 0.111, 95% CI = 0.053-0.169), low sleep efficiency (SE) (B = -0.015, 95% CI = -0.020 to -0.009), long sleep onset latency (SOL) (B = 0.009, 95% CI = 0.006-0.012), and low self-rated sleep quality (B = 0.112, 95% CI = 0.0992-0.124) at baseline were associated with increasing depressive symptoms over time. Conversely, more depressive symptoms at baseline were associated with an increasing 24-h activity rhythm fragmentation (B = 0.002, 95% CI = 0.001-0.003) and TIB (B = 0.009, 95% CI = 0.004-0.015), and a decreasing SE (B = -0.140, 95% CI = -0.196 to -0.084), SOL (B = 0.013, 95% CI = 0.008-0.018), and self-rated sleep quality (B = 0.193, 95% CI = 0.171-0.215) over time. CONCLUSION This study demonstrates a bidirectional association of 24-h activity rhythms, actigraphy-estimated sleep, and self-rated sleep quality with depressive symptoms over a time frame of multiple years in middle-aged and elderly persons.
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Affiliation(s)
- Maud de Feijter
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Desana Kocevska
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Annemarie I. Luik
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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50
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Schouten MJE, ten Have M, Tuithof M, de Graaf R, Dekker JJM, Goudriaan AE, Blankers M. Alcohol use as a predictor of the course of major depressive disorder: a prospective population-based study. Epidemiol Psychiatr Sci 2023; 32:e14. [PMID: 36847267 PMCID: PMC9971850 DOI: 10.1017/s2045796023000070] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
AIMS There are indications that problematic alcohol use may negatively impact the course of major depressive disorder (MDD). However, most studies on alcohol use and adverse MDD outcomes are conducted amongst MDD populations with (severe) alcohol use disorder in psychiatric treatment settings. Therefore, it remains unclear whether these results can be generalised to the general population. In light of this, we examined the longitudinal relationship between alcohol use and MDD persistence after a 3-year follow-up amongst people with MDD from the general population. METHODS Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a psychiatric epidemiological prospective study comprising four waves amongst the adult Dutch general population (n = 6.646). The study sample (n = 642) consisted of those with 12-month MDD who participated at the follow-up wave. The outcome was 12-month MDD persistence after the 3-year follow-up, which was assessed via the Composite International Diagnostic Interview version 3.0. Weekly alcohol consumption was operationalised as non-drinking (0 drinks), low-risk drinking (⩽7 drinks; reference), at-risk drinking (women 8-13 drinks, men 8-20 drinks) and high-risk drinking (women ⩾14, men ⩾21 drinks). We performed univariate and multiple logistic regression analyses, which were adjusted for various socio-demographic and health-related factors. RESULTS The majority (67.4%) of the MDD sample were female, while the mean age was 47.1 years. Amongst these, 23.8% were non-drinkers, 52.0% were low-risk drinkers and 14.3% and 9.4% were at-risk and high-risk drinkers, respectively. Around one-quarter of the sample (23.6%) met the criteria for a persistent MDD after 3-year follow-up. No statistically significant association was found between alcohol use and MDD persistence, either for the crude model or the adjusted models. In comparison to low-risk drinking, the full adjusted model showed no statistically significant associations between MDD persistence and non-drinking (odds ratio (OR) = 1.15, p = 0.620), at-risk drinking (OR = 1.25, p = 0.423), or high-risk drinking (OR = 0.74, p = 0.501). CONCLUSIONS Contrary to our expectations, our findings showed that alcohol use was not a predictor of MDD persistence after 3-year follow-up amongst people with MDD from the general population.
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Affiliation(s)
- Maria J. E. Schouten
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, Amsterdam Public Health research institute, Amsterdam, the Netherlands
- Author for correspondence: Maria J. E. Schouten, E-mail:
| | - Margreet ten Have
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marlous Tuithof
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Ron de Graaf
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Jack J. M. Dekker
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Anna E. Goudriaan
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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