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Cachexia and Dietetic Interventions in Patients With Esophagogastric Cancer: A Multicenter Cohort Study
Dijksterhuis, WPM ; Latenstein, AEJ ; Kleef, JJ van ; Verhoeven, RHA ; Vries, JHM de ; Slingerland, M ; Steenhagen, E ; Heisterkamp, J ; Timmermans, LM ; Schueren, M.A.E. de van der ; Oijen, MGH van ; Beijer, S ; Laarhoven, HWM van et al. sine al.
2021, Article / Letter to editor (Journal of the National Comprehensive Cancer Network, vol. 19, iss. 2, (2021), pp. 144-+)Background: Cachexia is common in patients with esophagogastric cancer and is associated with increased mortality. Nutritional screening and dietetic interventions can be helpful in preventing evolvement of cachexia. Our aim was to study the real-world prevalence and prognostic value of pretreatment cachexia on overall survival (OS) using patient-reported weight loss, and to explore dietetic interventions in esophagogastric cancer. Materials and Methods: Patients with esophagogastric cancer (2015-2018), regardless of disease stage, who participated in the Prospective Observational Cohort Study of Esophageal-Gastric Cancer Patients (POCOP) and completed patient-reported outcome measures were included. Data on weight loss and dietetic interventions were retrieved from questionnaires before start of treatment (baseline) and 3 months thereafter. Additional patient data were obtained from the Netherlands Cancer Registry. Cachexia was defined as self-reported >5% half-year body weight loss at baseline or >2% in patients with a body mass index (BMI) <20 kg/m(2) according to the Fearon criteria. The association between cachexia and OS was analyzed using multivariable Cox proportional hazard analyses adjusted for sex, age, performance status, comorbidities, primary tumor location, disease stage, histology, and treatment strategy. Results: Of 406 included patients, 48% had pretreatment cachexia, of whom 65% were referred for dietetic consultation at baseline. The proportion of patients with cachexia was the highest among those who received palliative chemotherapy (59%) or best supportive care (67%). Cachexia was associated with decreased OS (hazard ratio, 1.52; 95% CI, 1.11-2.09). Median weight loss after 3-month follow-up was lower in patients with cachexia who were referred to a dietician at baseline compared with those who were not (0% vs 2%; P=.047). Conclusions: Nearly half of patients with esophagogastric cancer have pretreatment cachexia. Dietetic consultation at baseline was not reported in more than one-third of the patients with cachexia. Because cachexia was independently associated with decreased survival, improving nutritional screening and referral for dietetic consultation are warranted to prevent further deterioration of malnutrition and mortality.
Cachexia, dietetic consultation, and survival in patients with pancreatic and periampullary cancer: A multicenter cohort study
Latenstein, AEJ ; Dijksterhuis, WPM ; Mackay, TM ; Beijer, S ; Eijck, CHJ van ; Hingh, IHJT de ; Molenaar, IQ ; Oijen, MGH van ; Santvoort, HC van ; Schueren, M.A.E. de van der ; Vos-Geelen, J de ; Vries, JHM de ; Wilmink, JW ; Besselink, MG ; Laarhoven, HWM van et al. sine al.
2021, Article / Letter to editor (Cancer Medicine (Malden, Ma), (2021))It is unclear to what extent patients with pancreatic cancer have cachexia and had a dietetic consult for nutritional support. The aim was to assess the prevalence of cachexia, dietitian consultation, and overall survival in these patients. This prospective multicenter cohort study included patients with pancreatic cancer, who participated in the Dutch Pancreatic Cancer Project and completed patient reported outcome measures (2015-2018). Additional data were obtained from the Netherlands Cancer Registry. Cachexia was defined as self-reported >5% body weight loss, or >2% in patients with a BMI <20 kg/m(2) over the past half year. The Kaplan-Meier method was used to analyze overall survival. In total, 202 patients were included from 18 centers. Cachexia was present in 144 patients (71%) and 81 of those patients (56%) had dietetic consultation. Cachexia was present in 63% of 94 patients who underwent surgery, 77% of 70 patients who received palliative chemotherapy and 82% of 38 patients who had best supportive care. Dietitian consultation was reported in 53%, 52%, and 71%, respectively. Median overall survival did not differ between patients with and without cachexia, but decreased in those with severe weight loss (12 months (IQR 7-20) vs. 16 months (IQR 8-31), p = 0.02), as compared to those with <10% weight loss during the past half year. Two-thirds of patients with pancreatic cancer present with cachexia of which nearly half had no dietetic consultation. Survival was comparable in patients with and without cachexia, but decreased in patients with more severe weight loss.
Campagne Eiwitwijs: gezond en fit met eiwit
Linschooten, J. ; Doedée, C. ; Mieghem, N. van ; Verwijs, M. ; Roodenburg, A. ; Schueren, M.A.E. de van der
2021, Article / Letter to editor (Nederlands Tijdschrift voor Voeding & Diëtetiek, vol. 76, iss. 2, (2021), pp. 40-41)
Can EHEA Students Mobility Analysis be used in Marketing Strategies?
Weber, T. ; Popescu, F.
2020, Article in monograph or in proceedings (Enterprise in the Global Economy: Challenges of the Current Global Environment, pp. 161-167)
Can mastication in children with cerebral palsy be analyzed by clinical observation, dynamic ultrasound and 3D kinematics?
Remijn, L. ; Groen, B.E. ; Speyer, R. ; Limbeek, J. van ; Vermaire, J.A. ; Engel-Hoek, L. van den ; -van der Sanden, M.W.G. Nijhuis
2017, Article / Letter to editor (Journal of Electromyography and Kinesiology, vol. 32, (2017), pp. 22-29)The aim of this study was to explore the feasibility of the Mastication Observation and Evaluation (MOE) instrument, dynamic ultrasound and 3D kinematic measurements to describe mastication in children with spastic cerebral palsy and typically developing children. Masticatory movements during five trials of eating a biscuit were assessed in 8 children with cerebral palsy, spastic type (mean age 9.08years) and 14 typically developing children (mean age 9.01years). Differences between trials were tested (t-test) and the mastication of individual children with cerebral palsy was analyzed. MOE scores ranged from 17 to 31 (median 24) for the children with cerebral palsy and from 28 to 32 (median 31) for the typically developing children. There was an increased chewing cycle duration, a smaller left-right and up-down tongue displacement and larger anterior mandible movements for the trials (n=40) of cerebral palsy children (p<0.000 for all comparisons) compared to the trials of typically developing children (n=70). The MOE captures differences in mastication between individual children with cerebral palsy. The MOE items 'jaw movement' and 'fluency and coordination' showed the most similarity with the objective measurements. Objective measurements of dynamic ultrasound and 3D kinematics complemented data from the MOE instrument.
Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines
Arends, J ; Strasser, F ; Gonella, S ; Solheim, TS ; Madeddu, C ; Ravasco, P ; Buonaccorso, L ; Schueren, M.A.E. de van der ; Baldwin, C ; Chasen, M ; Ripamonti, CI et al. sine al.
2021, Article / Letter to editor (Esmo Open, vol. 6, iss. 3, (2021))
Cancer cachexia: an overview of diagnostic criteria and therapeutic approaches for the accredited practicing dietitian
Meij, B.S. van der ; Teleni, L ; McCarthy, AL ; Isenring, EA
2021, Article / Letter to editor (Journal of Human Nutrition and Dietetics, vol. 34, iss. 1, (2021), pp. 243-254)Background: Cancer cachexia (CC) is a multifactorial syndrome characterised by ongoing skeletal muscle loss that leads to progressive functional impairment driven by reduced food intake and abnormal metabolism. Despite the traditional use of non-volitional weight loss as the primary marker of CC, there is no consensus on how to diagnose and manage CC. Methods: The aim of this narrative review was to describe and discuss diagnostic criteria and therapeutic approaches for the accredited practicing dietitian with respect to identifying and managing CC. Results: Available diagnostic criteria for cachexia include the cancer-specific (Fearon and Cachexia Score) and general criteria (Evans and Global Leadership Initiative on Malnutrition). These include phenotypic criteria [weight loss, body mass index, (objective) muscle mass assessments, quality of life] and aetiological criteria (disease burden, inflammation, energy expenditure, anorexia and inadequate food intake) and can be incorporated into the nutrition care process (NCP). This informs the nutrition diagnosis of 'chronic disease- or condition-related malnutrition (undernutrition) as related to increased nutrient needs, anorexia or diminished intake due to CC'. Optimal nutrition care and management of CC is multidisciplinary, corrects for increased energy expenditure (via immunonutrition/eicosapentaenoic acid), suboptimal protein/energy intake and poor nutrition quality of life, and includes a physical exercise intervention. Monitoring of intervention efficacy should focus on maintaining or slowing the loss of muscle mass, with weight change as an alternative gross indicator. Conclusions: Dietitians and the NCP can play an essential role with respect to identifying and managing CC, focusing on aspects of nutrition screening, assessment and intervention.
Cancer Cachexia: Identification by Clinical Assessment versus International Consensus Criteria in Patients with Metastatic Colorectal Cancer.
Werf, A. van der ; Bokhorst, Q.N.E. van ; Schueren, M.A.E. de van der ; Verheul, H.M.W. ; Langius, J.A.E.
2018, Article / Letter to editor (Nutrition and Cancer-An International Journal, (2018))
Cancer-associated anorexia: Validity and performance overtime of different appetite tools among patients at their first cancer diagnosis
Molfino, A ; Schueren, M.A.E. de van der ; Sanchez-Lara, K ; Milke, P ; Amabile, MI ; Imbimbo, G ; Lazzaro, L Di ; Cavuto, S ; Ronzani, G ; Snegovoy, A ; Gioulbasanis, I ; Laviano, A. et al. sine al.
2021, Article / Letter to editor (Clinical Nutrition, vol. 40, iss. 6, (2021), pp. 4037-4042)Background & aims: Anorexia is a frequent symptom in cancer and we aimed to assess its prevalence among patients at their first cancer diagnosis by different appetite tools and the relationship between each tool with self-reports of food intake. We also tested whether cancer anorexia influences outcomes independently of reduced food intake or body weight loss (BWL) overtime and whether BWL was associated with complications during anticancer-therapy. Methods: Functional Assessment of Anorexia/Cachexia Therapy (FAACT) score, self-assessment of appetite, Anorexia Questionnaire (AQ) and Visual Analog Scale (VAS) were administered. Percent of food intake was used as a criterion measure of anorexia. We registered BWL and anticancer-therapy complications over 3-month-follow-up. Results: 438 cancer patients from 7 cancer-centers worldwide were included. The prevalence of anorexia was 39.9% by FAACT score, 40.2% by VAS, 40.6% by the self-assessment of appetite and 65.4% by AQ. Low food intake (<50%) was reported in 28% of patients. All appetite tools correlated with food intake percent (P < 0.0001). We documented a correlation between self-assessment of appetite, FAACT score, VAS and BWL overtime (P < 0.04). The self-assessment of appetite (P = 0.0152) and the FAACT score (P = 0.043) were associated with BWL independently of anticancer therapies. Among patients with BWL, the risk to develop complications was greater with respect to those who maintained a stable or gained body weight (P = 0.03). Conclusions: In our sample of cancer patients, FAACT score and self-assessment of appetite performed well when low food intake was used as a criterion measure, and revealed an association of anorexia with BWL, which was, in turn, related to the development of anticancer-therapy complications. (c) 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Canon van HRM – 50 theorieën over een vakgebied in ontwikkeling
Osagie, E.R. ; Wielenga-Meijer, E.G.A. ; Lange, A.H. de
2019, Part of book or chapter of book (Canon van HRM – 50 theorieën over een vakgebied in ontwikkeling)
Capabilitarianisme: Capability approach voor gevorderden
Jansen, E.L.
2018, Book review (Journal of Social Intervention : Theory and Practice, (2018))
Capability Approach heeft potentie: reactie op Carin Wevers
Jansen, E.L.
2017, Article / Letter to editor (vol. 3, (2017), pp. 46)
De capability benadering, technologie en sociaal werk
Jansen, E.L.
2018, Part of book or chapter of book (De capabilitybenadering in het sociaal domein: een praktijkgerichte inleiding.)
Care Integration in Primary Dementia Care Networks: A Longitudinal Mixed-Methods Study
Oostra, D.L. ; Harmsen, A ; Nieuwboer, M.S. ; Olde Rikkert, M.G.M. ; Perry, M.
2021, Article / Letter to editor (International Journal of Integrated Care (Ijic), vol. 2021; 21(4, (2021))
Care resistant behaviour during oral examination in Dutch nursing home residents with dementia
Willems, MS ; Hollaar, V.R.Y. ; van der Maarel-Wierink, C ; Putten, GJ van der ; Satink, T.
2022, Article / Letter to editor (Gerodontology, (2022))
Care-resistant behaviour during oral examination in Dutch nursing home residents with dementia
Willems, MS ; Hollaar, V.R.Y. ; van der Maarel-Wierink, CD ; van der Putten, GJ ; Satink, T.
2022, Article / Letter to editor (Gerodontology, (2022))Objective To assess the occurrence and associations of verbal and non-verbal care-resistant behaviour (CRB) during oral examination by a dental hygienist in nursing home residents with dementia. Background CRB is a barrier to providing professional oral care and daily oral hygiene care. Understanding the predictors of CRB might help care professionals in learning to anticipate this behaviour. Methods In this multicentre cross-sectional study signs of verbal and non-verbal CRB were reported during the oral examination. Data collection occurred in the psychogeriatrics wards of 14 different nursing homes in the Netherlands (N = 367). Results A total of 367 residents were included. CRB was evident in 82 residents (22.3%), of whom 45 (55%) showed verbal and 37 (45%) non-verbal CRB. Associated with CRB were age >85 years, duration of residential stay longer than 2 years, and having Korsakov dementia. Other factors associated with CRB were duration of residential stay (categories ">2 and <= 4 years" or ">4 years") and having a natural dentition (P = .043-.005, OR = 1.20-1.33, 95% CI = 1.00-8.48). Significant associations for verbal and non-verbal CRB were age between 76 and 85 years, vascular dementia and Korsakov dementia (P = .031-.006, OR = .020-1.49, 95% CI = 0.43-2.15). Conclusion The occurrence of CRB was 22.3% and was associated with older age and longer duration of residential stay, Vascular and Korsakov dementia and natural dentition.
Career development, starting a family and participating in sport: a simultaneous exhibition? A study of Dutch adults’ narratives on the impact of major life events in emerging adulthood.
Houten, J. van
2019, Article in monograph or in proceedings (Parallel session of the European Association for Sociology of Sports Conference (EASS2019))Earlier quantitative research shows that major life events that mark the transition to adulthood (emerging adulthood) affect sport participation, mostly in a negative way. However, insight regarding the explanatory mechanisms behind these effects, which is needed to better prevent drop out and stimulate sport participation over the life course, is lacking. This qualitative study aims to fill this gap by investigating why people change their sport behaviour during emerging adulthood, specifically when major life events occur that mark this transition period within two life domains: the professional career (e.g. entering high/secondary school and higher education, leaving fulltime education, beginning to work) and the family domain (e.g. engaging in an intimate relationship, cohabitation, marriage, becoming a parent). Analysis of 45 Dutch adults’ narratives on their sport participation during the transition to adulthood and the role of these life events, revealed that when the life events occurred, new time consuming and physically and/or psychological demanding activities, roles and responsibilities arose that are more obligatory and fixed, and held higher social pay-offs then (existing) sport activities. This altered people’s daily routines and led to a reconfiguration of resources with (new) opportunities and constraints for sport participation. Based on this new resource balance and associated opportunities and constraints for sport participation, people made a deliberate choice on if sport participation fitted in their new life situation or not, and if so, in what way/how it fitted best. However, there was diversity in the choices that people made regarding (changing) their sport participation, based on different trade-offs between their opportunities and constraints for sport participation.
Case study supply chain finance: it platform for smes
Jansen, J.H. ; Wolter, A.
2021, Article in monograph or in proceedings (Case study supply chain finance: it platform for smes)
The centenary of the Harris-Benedict equations: How to assess energy requirements best? Recommendations from the ESPEN expert group
Bendavid, I ; Lobo, DN ; Barazzoni, R. ; Cederholm, T. ; Coeffier, M ; Schueren, M.A.E. de van der ; Fontaine, E ; Hiesmayr, M. ; Laviano, A. ; Pichard, C ; Singer, P. et al. sine al.
2021, Article / Letter to editor (Clinical Nutrition, vol. 40, iss. 3, (2021), pp. 690-701)Background & aims: The year 2019 marked the centenary of the publication of the Harris and Benedict equations for estimation of energy expenditure. In October 2019 a Scientific Symposium was organized by the European Society for Clinical Nutrition and Metabolism (ESPEN) in Vienna, Austria, to celebrate this historical landmark, looking at what is currently known about the estimation and measurement of energy expenditure. Methods: Current evidence was discussed during the symposium, including the scientific basis and clinical knowledge, and is summarized here to assist with the estimation and measurement of energy requirements that later translate into energy prescription. Results: In most clinical settings, the majority of predictive equations have low to moderate performance, with the best generally reaching an accuracy of no more than 70%, and often lead to large errors in estimating the true needs of patients. Generally speaking, the addition of body composition measurements did not add to the accuracy of predictive equations. Indirect calorimetry is the most reliable method to measure energy expenditure and guide energy prescription, but carries inherent limitations, greatly restricting its use in real life clinical practice. Conclusions: While the limitations of predictive equations are clear, their use is still the mainstay in clinical practice. It is imperative to recognize specific patient populations for whom a specific equation should be preferred. When available, the use of indirect calorimetry is advised in a variety of clinical settings, aiming to avoid under-as well as overfeeding. (C)2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Challenges of Identifying Communities with Shared Semantics in Enterprise Modeling
Linden, D. van der ; Hoppenbrouwers, S.J.B.A.
2012, Article / Letter to editor (The Practice of Enterprise Modeling, vol. 2012, iss. 134, (2012), pp. 160-171)In this paper we discuss the use and challenges of identifying communities with shared semantics in Enterprise Modeling. People tend to understand modeling meta-concepts (i.e., a modeling language’s constructs or types) in a certain way and can be grouped by this understanding. Having an insight into the typical communities and their composition (e.g., what kind of people constitute a semantic community) would make it easier to predict how a conceptual modeler with a certain background will generally understand the meta-concepts he uses, which is useful for e.g., validating model semantics and improving the efficiency of the modeling process itself. We demonstrate the use of psychometric data from two studies involving experienced (enterprise) modeling practitioners and computing science students to find such communities, discuss the challenge that arises in finding common real-world factors shared between their members to identify them by and conclude that the common (often implicit) grouping properties such as similar background, focus and modeling language are not supported by empirical data.
Changes in Health and Health Behavior Associated With Retirement
Mykletun, Reidar ; Furunes, Trude ; Solem, Per Erik ; Syse, Astri ; Veenstra, Marijke
2015, Article / Letter to editor (Journal of Aging & Health, vol. 2015, iss. December, (2015), pp. 1-29)Objectives: While poor health contributes to early work exits, it is less clear how early work exits affect health. This study therefore examines changes in health associated with retirement. Method: Survey data from gainfully employed individuals aged 57 to 66 in 2002 were used to assess changes in health status and behaviors associated with retirement (49%) 5 years later (N = 546). Results: Compared with workers, retirees were more likely to report improvements in mental health (odds ratio [OR] = 1.67), and less likely to report mental health deteriorations (OR = 0.56). Retirees were more likely to both increase (OR = 2.03) and reduce (OR = 1.87) their alcohol intake, and to increase physical activity (OR = 2.01) and lose weight (OR = 1.75). Discussion: As welfare states aim to extend working life to counteract repercussions of population aging, findings on possible health benefits for retirees may warrant more focus on the pros and cons of a prolonged working life.
Changes in motor-flexibility following anterior cruciate ligament reconstruction as measured by means of a leg-amplitude differentiation task with haptic and visual feedback.
Roelofsen, E.G.J. ; Cingel, R. van ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G. ; Meulenbroek, R.G.J.
2020, Article / Letter to editor (Clinical Biomechanics, vol. 80, (2020), pp. 105186)BACKGROUND: In the current study changes in lower-limb motor flexibility of patients undergoing Anterior Cruciate Ligament Reconstruction were evaluated in relation to fear of harm. METHODS: Fourteen patients were measured pre- and post-surgery, and data were compared to those of a single measurement in fifteen controls. Lower-limb motor-flexibility was assessed in treadmill-walking and a cyclic leg-amplitude differentiation task augmented with haptic or visual feedback. Flexibility was captured by determining the between-leg coordination-variability (SD of relative phase) and each leg's temporal variability (sample entropy). Patients were post hoc divided into a higher-fear-group (pre-surgery: n = 6, post-surgery: n = 7) and a lower-fear-group (pre-surgery: n = 6, post-surgery: n = 7) by means of a median split of their scores on a self-reported fear of harm scale. Differences in flexibility-measures between the higher-fear-group and the lower-fear-group were also assessed. FINDINGS: No pre- and post-surgery differences, nor differences with the control group, were found in motor-flexibility during treadmill-walking but the post-surgery higher-fear-group did show lower values of SD relative phase. In the leg-amplitude differentiation task the SD of the relative phase decreased but sample entropy increased post-surgery towards levels of the control-group. The pre-surgery higher-fear-group showed lower values of sample entropy in visual conditions. INTERPRETATION: While gait kinematics may not show motor-flexibility changes following anterior cruciate ligament reconstruction, a leg-amplitude differentiation task does show such changes. Differentiating patients on a fear-of-harm scale revealed subtle differences in motor-flexibility. Challenging patients with non-preferred movements such as amplitude differentiation may be a promising tool to evaluate motor-flexibility following ACLR.
Chapter 13: De statistiek van de polikliniek
Groen, A. ; Moeke, D.
2020, Part of book or chapter of book (Berden, B.; Windi, W.; Merode, F. van (ed.), Capaciteitsplanning in de zorg)
Chapter 13: How similarities and differences between sports lead to talent transfer: A process approach
Pion, J.A.J. ; Teunissen, A.J.W. ; Welle, S. ter ; Spruijtenburg, G. ; Faber, I.R. ; Lenoir, M.
2020, Part of book or chapter of book (Baker, J.; Cobley, S.; Schorer, J. (ed.), Talent Identification and Development in Sport: International Perspectives)
Chapter 22: Healthy healthcare: results of a large-scale project in 25 different healthcare organizations examining effects of a self-leadership versus a Team leadership intervention
Lange, A.H. de ; Pak, K. ; Vuuren, T. van ; Dorsen, P. van ; Osagie, E.R. ; Verhoeven, T. ; Pijnappels, M.C.M. ; Neure, S. van
2020, Part of book or chapter of book (Lovseth, L.; Lange, A.H. de (ed.), Integrating organization of health services, worker wellbeing and quality of care: Towards ‘healthy healthcare’)
Chapter 6. Removing challenges for building resilience with support of the circular economy
Rijke, J.S. ; Geerling, L. ; Quan, N.H. ; Trung, N.
2020, Part of book or chapter of book (Climate Resilient Urban Area)
Chapter 8: Capacity planning in healthcare: finding solutions for healthy planning in nursing home care
Moeke, D. ; Bekker, René
2020, Part of book or chapter of book (Lovseth, L.; Lange, A.H. de (ed.), Integrating organization of health services, worker wellbeing and quality of care: Towards ‘healthy healthcare’)
Chapter 8: Finding talent and establishing the road to excellence in table tennis – The Dutch Case
Faber, I.R. ; Damsma, T. ; Pion, J.A.J.
2020, Part of book or chapter of book (Baker, J.; Cobley, S.; Schorer, J. (ed.), Talent Identification and Development in Sport: International Perspectives)
The characteristics and pre-hospital management of blunt trauma patients with suspected spinal column injuries: a retrospective observational study
Oosterwold, JT ; Sagel, DC ; van Grunsven, PM ; Holla, M ; de Man-van Ginkel, J ; Berben, S
2017, Article / Letter to editor (European Journal of Trauma and Emergency Surgery, vol. 43, iss. 4, (2017), pp. 513-524)Background Pre-hospital spinal immobilisation by emergency medical services (EMS) staff is currently the standard of care in cases of suspected spinal column injuries. There is, however, a lack of data on the characteristics of patients who received spinal immobilisation during the pre-hospital phase and on the adverse effects of immobilisation. The objectives of this study were threefold. First, we determined the pre-hospital characteristics of blunt trauma patients with suspected spinal column injuries who were immobilised by EMS staff. Second, we assessed the choices made by EMS staff regarding spinal immobilisation techniques and reasons for immobilisation. Third, we researched the possible adverse effects of immobilisation. Design A retrospective observational study in a cohort of blunt trauma patients. Study method Data of blunt trauma patients with suspected spinal column injuries were collected from one EMS organisation between January 2008 and January 2013. Coded data and free text notes were analysed. Results A total of 1082 patients were included in this study. Spinal immobilisation was applied in 96.3 % of the patients based on valid pre-hospital criteria. In 2.1 % of the patients immobilisation was not based on valid criteria. Data of 1.6 % patients were missing. Main reasons for spinal immobilisation were posterior midline spinal tenderness (37.2 % of patients) and painful distracting injuries (13.5 % of patients). Spinal cord injury (SCI) was suspected in 5.7 % of the patients with posterior midline spinal tenderness. A total of 15.8 % patients were immobilised using non-standard methods. The reason for departure from the standard method was explained for 3 % of these patients. Reported adverse effects included pain (n = 10, 0.9 %,); shortness of breath (n = 3, 0.3 %); combativeness or anxiety (n = 6, 0.6 %); and worsening of pain when supine (n = 1, 0.1 %). Conclusion/recommendation Spinal immobilisation was applied in 96.3 % of all included patients based on pre-hospital criteria. We found that consensus among EMS staff on how to interpret the criterion 'distracting injury' was lacking. Furthermore, the adverse effects of spinal immobilisation were incompletely documented in pre-hospital care reports. To provide validated information on potential symptoms of SCI, a uniform EMS scoring system for motoric assessment should be developed.
Characteristics of non-conveyance ambulance runs: A retrospective study in the Netherlands
Ebben, R.H.A. ; Castelijns, M. ; Frenken, J. ; Vloet, L.C.M.
2019, Article / Letter to editor (World Journal of Emergency Surgery, vol. 10, iss. 4, (2019), pp. 239-243)
Characterization of Social Risk Factors Among Newborns Seen at an Urban Pediatric Primary Care Predictive of Appointment Nonattendance During the First 6 Months of Life.
Lefchak, B. ; Cushwa, A. ; Kersten, H. ; Courts, K. ; McPeak, K.
2022, Article / Letter to editor (Health Equity, vol. 6, iss. 1, (2022), pp. 40-48)Purpose: Appointment attendance is critical in monitoring health and well-being of children. Low income Medicaid-insured families with newborns often experience social risks that may affect attendance. This project sought to characterize social risk factors present at first newborn visits predictive of future appointment nonattendance. Methods: Retrospective cohort study of minority and Medicaid-insured population at St. Christopher's Hospital for Children using a standardized social risk screener administered at first newborn visits as part of routine clinical care. In total, 720 survey responses between December 2016 and June 2017 were correlated with electronic health record-derived sociodemographic and appointment attendance data in the first 6 months of life. Nonattendance included missed and canceled appointments. Caregiver-reported social risk factors were included as covariates in linear regressions predicting proportion nonattendance outcomes. Results: Newborn caregivers identified many social risk factors including mental health diagnoses (14%), lack of child care support (45%), and food insecurity (9%). Approximately 74% had nonattendance with 41% missing or canceling a quarter or more appointments. Number of siblings (p<0.01) and maternal age (p<0.01) were most predictive for nonattendance, respectively. Other social risks were not significant except for maternal mental health (p=0.01) among those identifying number of risk factors above cohort average (16%). Conclusion: Screening of newborns at first medical visits can be used to characterize social risks. Most social risk factors at first visits were not strongly predictive of nonattendance, although our results suggested associations between non-attendance and maternal demographics, mental health and household makeup.
Childhood trauma and negative memory bias as shared risk factors for psychopathology and comorbidity in a naturalistic psychiatric patient sample
Koekkoek, B.W. ; Vrijsen, Janna ; Amen, Camiel van ; Oostrom, Iris van ; Schene, A. ; Tendolkar, Indira
2017, Article / Letter to editor (Brain and Behavior, (2017), pp. 1-8)Background: Both childhood trauma and negative memory bias are associated with the onset and severity level of several psychiatric disorders, such as depression and anxiety disorders. Studies on these risk factors, however, generally use homogeneous noncomorbid samples. Hence, studies in naturalistic psychiatric samples are lacking. Moreover, we know little about the quantitative relationship between the frequency of traumatic childhood events, strength of memory bias and number of comorbid psychiatric disorders; the latter being an index of severity. The current study examined the association of childhood trauma and negative memory bias with psychopathology in a large naturalistic psychiatric patient sample. Methods: Frequency of traumatic childhood events (emotional neglect, psychological-, physical- and sexual abuse) was assessed using a questionnaire in a sample of 252 adult psychiatric patients with no psychotic or bipolar- I disorder and no cognitive disorder as main diagnosis. Patients were diagnosed for DSM-V Axis-I and Axis-II disorders using a structured clinical interview. This allowed for the assessment of comorbidity between disorders. Negative memory bias for verbal stimuli was measured using a computer task. Results: Linear regression models revealed that the frequency of childhood trauma as well as negative memory bias was positively associated with psychiatric comorbidity, separately and above and beyond each other (all p <.01). Conclusions: The results indicate that childhood trauma and negative memory bias may be of importance for a broader spectrum of psychiatric diagnoses, besides the frequently studied affective disorders. Importantly, frequently experiencing traumatic events during childhood increases the risk of comorbid psychiatric disorders.
Children's perspectives on living and growing up as at home as possible. A participatory research with children living in residential care
Peelen, J. ; Saedt, M.
2021, Article in monograph or in proceedings (EUSARF 2012. Conference XVI "The perspective of the child")
Children, Co-creation and Content Generating AI’s Towards an understanding of co-creating with children and content generating AI’s
Sappelli, M. ; Sluis-Thiescheffer, W.
2022, Article in monograph or in proceedings (NordiCHI workshop - Age against the machine: A Call for Designing Ethical AI for and with Children)With the development of content-generating Artificial Intelligence (AI) systems, such as generating images from a textual description, new possibilities for using such system in design processes arise. In this position paper, we argue that we need to explicitly incorporate children's values when we develop design methods that incorporate content-generating AI to protect their creative processes. In a mini-inquiry we find that children from different ages have articulate ideas about being in the same design space as a content-generating AI’s. They share concerns about fidelity, transparency and how it changes the level-playing field for them. To setup a safe and ethical design space when co-creating with children we foresee three important steps: 1) explore the value of children with respect to content-generation AI. 2) improve the accessibility of these systems for children and 3) study the effect of using such a system on creativity and innovation in a design process.
Chlorhexidine solution and pneumonia in care-dependent elderly people
Hollaar, V.R.Y.
2017, Dissertation
Chocoladeletter
Vlijmen, Jorcho van
2019, Contribution for newspaper or weekly magazine (Brabants Dagblad, 5 december 2019)
Choices in scale, guided by quality or legislation? : The influence of institutional factors on assisted living facilities
Spierings, Dort
2011, Article / Letter to editor (Tussenstand, vol. 2012, (2011))Since the eighties, Dutch residents of care homes have been housed in Assisted Living Facilities (ALFs) in order to age in place and live with higher social quality of housing. Scale, group mix and social quality of housing of these ALFs has not yet been explored. Initiators decide on experience and intuition or guided by policy and exploitation. The question arises: Are choices in scale for assisted living facilities based on quality factors or guided by institutional influences as legislation and financing? A desk research of 593 projects was made besides a multiple case study in 24 projects. Significant relations were found, partly in line with presuppositions on quality drivers, partly inexplicable. Comparing these incongruities with changes in legislation and financing, plausible relations were found. This leads to the conclusion that decisions for ALFs are based more on institutional factors and less strictly on quality choices than is avowed.
‘Chronisch’ worden in de psychiatrie : De invloed van GGZ-hulpverlening op chroniciteit
Koekkoek, B.W.
2011, Article / Letter to editor (MGV: Maandblad Geestelijke Volksgezondheid, vol. 66, iss. 4, (2011), pp. 222-235)Chroniciteit van psychiatrische ziekte is geen objectieve waarheid maar een concept dat door de jaren heen en vanuit uiteenlopende invalshoeken verschillend is gedefinieerd. In dit artikel wordt stilgestaan bij het interpersoonlijke karakter van het geven en ontvangen van chronische zorg. Met theorie, voorbeelden en casuïstiek wordt de stelling onderbouwd dat een zeer hulpvaardige houding van ggzprofessionals chroniciteit kan uitlokken of versterken. Aan de hand van casuïstiek en drie gespreksmethoden wordt geïllustreerd hoe dit anders kan, waardoor de professional zich mogelijk minder machteloos en de cliënt zich krachtiger voelt.
Circulaire Oogst
Croes, F.
2018, Book (monograph)
Circulating cardiac troponin T exhibits a diurnal rhythm.
Klinkenberg, L.J. ; Dijk, J.W. van ; Tan, F.E. ; Loon, L.J.C. van ; Dieijen-Visser, M.P. van ; Meex, S.J.
2014, Article / Letter to editor (Journal of the American College of Cardiology, vol. 63, iss. 17, (2014), pp. 1788-1795)OBJECTIVES: The goal of this study was to test the unverified assumption that chronically elevated cardiac troponin T (cTnT) levels fluctuate randomly around a homeostatic set point. BACKGROUND: The introduction of high-sensitivity cardiac troponin (cTn) assays has improved sensitivity for acute myocardial infarction (AMI). However, many patients with a single positive cTn test result do not have AMI. Therefore, the diagnosis of AMI relies strongly on serial testing and interpretation of cTn kinetics. Essential in this regard is a profound understanding of the biological variation of cTn. METHODS: Two studies were conducted to assess biological cTnT variation and to investigate the presence of a diurnal rhythm of cTnT. Study 1 comprised 23 male subjects with type 2 diabetes, with no acute cardiovascular disease. Serial venous blood samples were drawn over an 11-h period (8:30 am to 7:30 pm). In study 2, the presence of a diurnal cTnT rhythm was investigated by hourly sampling of 7 subjects from study 1 over 25 h. RESULTS: In study 1, we observed a gradual decrease in cTnT concentrations during the day (24 ± 2%). This decrease was present in all participants and was most prominent in subjects with the highest baseline cTnT values (Pearson's R 0.93). Diurnal variation of cTnT, as assessed in study 2, was characterized by peak concentrations during morning hours (8:30 am, 17.1 ± 2.9 ng/l), gradually decreasing values during daytime (8:30 pm, 11.9 ± 1.6 ng/l), and rising concentrations during nighttime (8:30 am the next day, 16.9 ± 2.8 ng/l). CONCLUSIONS: A diurnal cTnT rhythm substantiates the recommendation that all dynamic changes in cTnT should be interpreted in relation to the clinical presentation. Epidemiological studies and risk-stratification protocols with the use of cTnT may benefit from standardized sampling times. (Exercise and Glycemic Control in Type 2 Diabetes; NCT00945165).
CiVi: circular genome visualization with unique features to analyze sequence elements.
Overmars, L. ; Hijum, S.A. van ; Siezen, R.J. ; Francke, C.
2015, Article / Letter to editor (Bioinformatics, vol. 31, iss. 17, (2015), pp. 2867-2869)We have developed CiVi, a user-friendly web-based tool to create custom circular maps to aid the analysis of microbial genomes and sequence elements. Sequence related data such as gene-name, COG class, PFAM domain, GC%, and subcellular location can be comprehensively viewed. Quantitative gene-related data (e.g. expression ratios or read counts) as well as predicted sequence elements (e.g. regulatory sequences) can be uploaded and visualized. CiVi accommodates the analysis of genomic elements by allowing a visual interpretation in the context of: (i) their genome-wide distribution, (ii) provided experimental data and (iii) the local orientation and location with respect to neighboring genes. CiVi thus enables both experts and non-experts to conveniently integrate public genome data with the results of genome analyses in circular genome maps suitable for publication. CONTACT: L.Overmars@gmail.com SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online. AVAILABILITY AND IMPLEMENTATION: CiVi is freely available at http://civi.cmbi.ru.nl.
Classification of employment factors according to the International Classification of Functioning, Disability and Health in patients with neuromuscular diseases: a systematic review.
Minis, Marie-Antoinett van ; Heerkens, Y.F. ; Engels, J.A. ; Oostendorp, R. ; Engelen, B. van
2009, Article / Letter to editor (Disability and Rehabilitation, vol. 31, iss. 26, (2009), pp. 2150-2163)PURPOSE: A systematic evaluation of the literature to identify health and contextual factors associated with employment in patients with neuromuscular diseases (NMD) and to perform a best evidence synthesis, taking into account the design of studies, methodological quality and the statistical significance of findings. METHOD: Publications were retrieved by a computerised search in medical and psychological databases. Two reviewers assessed titles and abstracts first and assessed the quality of the remaining full text publications independently as well. Of the residual publications, health and contextual factors associated with employment in patients with NMD were extracted. The factors found were included in a recently developed expanded International Classification of Functioning, Disability and Health scheme. RESULTS: Six hundred and sixty-two titles and abstracts were screened. The main reason to exclude a title and/or abstract was the absence of the study population selected: Facioscapulohumeral Muscular Dystrophy (FSHD), Hereditary Motor and Sensory Neuropathy (HMSN) & Myotonic Dystrophy (MD). Of the remaining 20 full-text publications, eight publications fulfilled the inclusion criteria: two repeated survey designs and six cross-sectional studies. Factor extraction resulted in 94 factors related to employment. Ten factors in five publications were indicative for an association with employment status: Disease related factors HMSN, MD & NMD in general), factors related to functions (physical functions, muscle power functions), general personal factors (age, gender and education), work related personal factors (type of occupation, and expressed interest in employment by patients with NMD). CONCLUSION: In the best evidence synthesis ten factors were indicative for an association with employment status in patients with NMD in five publications with good to excellent methodological quality.
Classification of forefoot pain based on plantar pressure measurements.
Keijsers, N.L.W. ; Stolwijk, N.M. ; Louwerens, J.W. ; Duysens, J.
2013, Article / Letter to editor (Clinical Biomechanics, vol. 28, iss. 3, (2013), pp. 350-356)BACKGROUND: Plantar pressure is widely used to evaluate foot complaints. However, most plantar pressure studies focus on the symptomatic foot with foot deformities. The purposes of this study were to investigate subjects without clear foot deformities and to identify differences in plantar pressure pattern between subjects with and without forefoot pain. The second aim was to discriminate between subjects with and without forefoot pain based on plantar pressure measurements using neural networks. METHODS: In total, 297 subjects without foot deformities of whom almost 50% had forefoot pain walked barefoot over a pressure plate. Foot complaints and subject characteristics were assessed with a questionnaire and a clinical evaluation. Plantar pressure was analyzed using a recently developed method, which produced pressure images of the time integral, peak pressure, mean pressure, time of activation and deactivation, and total contact time per pixel. After pre-processing the pressure images with principal component analysis, a forward selection procedure with neural networks was used to classify forefoot pain. FINDINGS: The pressure-time integral and mean pressure were significantly larger under the metatarsals II and III for subjects with forefoot pain. A neural network with 14 input parameters correctly classified forefoot pain in 70.4% of the test feet. INTERPRETATION: The differences in plantar pressure parameters between subjects with and without forefoot pain were small. The reasonable performance of forefoot pain classification by neural networks suggests that forefoot pain is related more to the distribution of the pressure under the foot than to the absolute values of the pressure at fixed locations.
Clients’ Perspectives on Integrated Care between Social Work and Financial- and Employment Services: A Case Study in the Netherlands.
Nouwen, C. ; Havens, L. ; Van Reenen, K. ; Driesen, I. ; Verharen, L. ; Van Regenmortel, T.
2023, Article / Letter to editor (Journal of Social Service Research, vol. 49, iss. 1, (2023), pp. 1-14)
Climate Control of a Greenhouse with Concentrating Solar Power System : International Conference on Agricultural Engineering
Sonneveld, P.J. ; Bochove, I. van
2013, Article in monograph or in proceedings (International Conference on Agricultural Engineering)There are several greenhouses built with solar panels integrated into the roof. In summer time this will operate very well, although broad shadow stripes can result in growth and yield differences. In winter the amount of sunlight is further limited by the solar panels and will result in further reduction of light accession to the cultivation space. As a result, the crops suffer from growth problems. These drawbacks are eliminated by the application of Concentrating Power Systems (CSP) with Fresnel lenses. A Fresnel lens works like a normal lens but is much thinner. When the sun shines, the lens receives both direct and indirect sunlight. The lens will concentrate all direct sunlight, which can be collected as thermal energy in the focal point. This absorbed radiation can be converted with an absorption cooler into cold water for cooling. This cold water can cool the greenhouse without the need of water use. The indirect solar radiation, the diffuse light will not focus and is therefore available as a fairly constant light source in the building or in the greenhouse. The capture of all direct radiation at high intensities will diminish the incoming heat load, which is useful for a better internal climate control of greenhouses and buildings. This lower heat load makes it easier to keep the greenhouse cool with the absorber. In this study the details of energy flows and thermal conversion with absorption cooler is determined. Calculation shows a 47% heat load reduction (from 337 W/m2 to 157 W/m2) with the Fresnel lenses in the covering of the greenhouse. In the case of the collector in focus, only 48% of the captured direct radiation, available as thermal energy, is required to cool the greenhouse further with an absorption cooler. Cooling a greenhouse can result in up to 90% reduction in water consumption of the cultivation. The possibility of light regulation is another important advantage the Fresnel lenses have. The light amount can vary between 15 – 77% of the incoming radiation. The access of the generated energy can be used for extra illumination (light and energy regulation) and/or energy supply and/or a desalination system.
Clinical course of pain and disability following primary lumbar discectomy: systematic review and meta-analysis.
Rushton, A. ; Heneghan, N.R. ; Heymans, M.W. ; Staal, J.B. ; Goodwin, P.
2020, Article / Letter to editor (European Spine Journal, vol. 29, iss. 7, (2020), pp. 1660-1670)PURPOSE: To conduct a meta-analysis to describe clinical course of pain and disability in adult patients post-lumbar discectomy (PROSPERO: CRD42015020806). METHODS: Sensitive topic-based search strategy designed for individual databases was conducted. Patients (>n16 years) following first-time lumbar discectomy for sciatica/radiculopathy with no complications, investigated in inception (point of surgery) prospective cohort studies, were included. Studies including revision surgery or not published in English were excluded. Two reviewers independently searched information sources, assessed eligibility at title/abstract and full-text stages, extracted data, assessed risk of bias (modified QUIPs) and assessed GRADE. Authors were contacted to request raw data where data/variance data were missing. Meta-analyses evaluated outcomes at all available time points using the variance-weighted mean in random-effect meta-analyses. Means and 95% CIs were plotted over time for measurements reported on outcomes of leg pain, back pain and disability. RESULTS: A total of 87 studies (nn=n31,034) at risk of bias (49 moderate, 38 high) were included. Clinically relevant improvements immediately following surgery (>nMCID) for leg pain (0-10, mean before surgery 7.04, 50 studies, nn=n14,910 participants) and disability were identified (0-100, mean before surgery 53.33, 48 studies, nn=n15,037). Back pain also improved (0-10, mean before surgery 4.72, 53 studies, nn=n14,877). Improvement in all outcomes was maintained (to 7 years). Meta-regression analyses to assess the relationship between outcome data and a priori potential covariates found preoperative back pain and disability predictive for outcome. CONCLUSION: Moderate-level evidence supports clinically relevant immediate improvement in leg pain and disability following lumbar discectomy with accompanying improvements in back pain. These slides can be retrieved under Electronic Supplementary Material.
Clinical leadership and integrated primary care: A systematic literature review
Nieuwboer, M.S. ; Sande, W.M.M. van der ; Marck, M.A. van der ; Olde Rikkert, M.G.M. ; Perry, M.
2018, Article / Letter to editor (European Journal of General Practice, vol. 2018, (2018), pp. 1-12)
Clinical leadership training in integrated primary care networks: a qualitative evaluation
Nieuwboer, M.S. ; van der Sande, R ; Olde Rikkert, M.G.M. ; Marck, M.A. van der ; Perry, M.
2022, Article / Letter to editor (Integrated Healthcare Journal, (2022))
Clinical Oncology Society of Australia: Position statement oncancer-relatedmalnutrition and sarcopenia
Kiss, N ; Loeliger, J ; Findlay, M ; Isenring, EA ; Baguley, BJ ; Boltong, A ; Butler, A ; Deftereos, I ; Eisenhuth, M ; Fraser, SF ; Fichera, R ; Griffin, H ; Hayes, S ; Jeffery, E ; Johnson, C ; Lomma, C ; Meij, B.S. van der ; McIntyre, C ; Nicholls, T ; Pugliano, L ; Skinner, T ; Stewart, J ; Bauer, J. et al. sine al.
2020, Article / Letter to editor (Nutrition & Dietetics: Journal of Dietitians Australia, vol. 77, iss. 4, (2020), pp. 416-425)This position statement describes the recommendations of the Clinical Oncology Society of Australia (COSA) regarding management of cancer-related malnutrition and sarcopenia. A multidisciplinary working group completed a review of the literature, focused on evidence-based guidelines, systematic reviews and meta-analyses, to develop recommendations for the position statement. National consultation of the position statement content was undertaken through COSA members. All people with cancer should be screened for malnutrition and sarcopenia in all health settings at diagnosis and as the clinical situation changes throughout treatment and recovery. People identified as "at risk" of malnutrition or with a high-risk cancer diagnosis or treatment plan should have a comprehensive nutrition assessment; people identified as "at risk" of sarcopenia should have a comprehensive evaluation of muscle status using a combination of assessments for muscle mass, muscle strength and function. All people with cancer-related malnutrition and sarcopenia should have access to the core components of treatment, including medical nutrition therapy, targeted exercise prescription and physical and psychological symptom management. Treatment for cancer-related malnutrition and sarcopenia should be individualised, in collaboration with the multidisciplinary team (MDT), and tailored to meet needs at each stage of cancer treatment. Health services should ensure a broad range of health care professionals across the MDT have the skills and confidence to recognise malnutrition and sarcopenia to facilitate timely referrals and treatment. The position statement is expected to provide guidance at a national level to improve the multidisciplinary management of cancer-related malnutrition and sarcopenia.
Clinical Practice Guideline for PhysicalTherapy Assessment and Treatment in Patients With Nonspecific Neck Pain.
Bier, J.D. ; Scholten-Peeters, W.G.M. ; Staal, J.B. ; Pool, J. ; Tulder, M.W. van ; Beekman, E. ; Knoop, J. ; Meerhoff, G. ; Verhagen, A.P.
2018, Article / Letter to editor (Physical Therapy, vol. 98, iss. 3, (2018), pp. 162-171)

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