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Lutke Schipholt IJ, Coppieters MW, Diepens M, Hoekstra T, Ostelo RWJG, Barbe MF, Meijer OG, Bontkes HJ, Scholten-Peeters GGM. Systemic Inflammation, Sleep, and Psychological Factors Determine Recovery Trajectories for People With Neck Pain: An Exploratory Study. J Pain 2024:S1526-5900(24)00377-8. [PMID: 38342190 DOI: 10.1016/j.jpain.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/13/2024]
Abstract
We conducted an explorative prospective cohort study with 6 months follow-up to 1) identify different pain and disability trajectories following an episode of acute neck pain, and 2) assess whether neuroimmune/endocrine, psychological, behavioral, nociceptive processing, clinical outcome, demographic and management-related factors differ between these trajectories. Fifty people with acute neck pain (ie, within 2 weeks of onset) were included. At baseline, and at 2, 4, 6, 12, and 26 weeks follow-up, various neuroimmune/endocrine (eg, inflammatory cytokines and endocrine factors), psychological (eg, stress symptoms), behavioral (eg, sleep disturbances), nociceptive processing (eg, condition pain modulation), clinical outcome (eg, trauma), demographic factors (eg, age), and management-related factors (eg, treatment received) were assessed. Latent class models were performed to identify outcome trajectories for neck pain and disability. Linear mixed models or the Pearson chi-square test were used to evaluate differences in these factors between the trajectories at baseline and at each follow-up assessment and over the entire 6 months period. For pain, 3 trajectories were identified. The majority of patients were assigned to the "Moderate pain - Favourable recovery" trajectory (n = 25; 50%) with smaller proportions assigned to the "Severe pain - Favourable recovery" (n = 16; 32%) and the "Severe pain - Unfavourable recovery" (n = 9; 18%) trajectories. For disability, 2 trajectories were identified: "Mild disability - Favourable recovery" (n = 43; 82%) and "Severe disability - Unfavourable recovery" (n = 7; 18%). Ongoing systemic inflammation (increased high-sensitive C-reactive protein), sleep disturbances, and elevated psychological factors (such as depression, stress and anxiety symptoms) were mainly present in the unfavorable outcome trajectories compared to the favorable outcome trajectories. PERSPECTIVE: Using exploratory analyses, different recovery trajectories for acute neck pain were identified based on disability and pain intensity. These trajectories were influenced by systemic inflammation, sleep disturbances, and psychological factors.
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Affiliation(s)
- Ivo J Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam University Medical Centre, Location Vrije Universiteit, Amsterdam, Noord Holland, The Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; School of Health Sciences and Social Work, and Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Queensland, Australia
| | - Maaike Diepens
- Department Family Medicine, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and the Amsterdam Public Health Research Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Noord Holland, The Netherlands
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute Amsterdam, Amsterdam, Noord Holland, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit, Amsterdam Movement Sciences Research Institute, Amsterdam, Noord Holland, The Netherlands
| | - Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Onno G Meijer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; Orthopaedic Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, PR China
| | - Hetty J Bontkes
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam University Medical Centre, Location Vrije Universiteit, Amsterdam, Noord Holland, The Netherlands
| | - Gwendolyne G M Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands
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van der Hoeven M, van Lettow M, Boonstra P, Hoekstra T, Rutebemberwa E, Tweheyo R, Kok MO. Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda. BMJ Open 2024; 14:e074393. [PMID: 38316585 PMCID: PMC10860046 DOI: 10.1136/bmjopen-2023-074393] [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: 04/05/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE To assess the uptake of services provided by community health workers who were trained as community health entrepreneurs (CHEs) for febrile illness and diarrhoea. DESIGN A cross-sectional survey among households combined with mapping of all providers of basic medicine and primary health services in the study area. PARTICIPANTS 1265 randomly selected households in 15 rural villages with active CHEs. SETTING Bunyangabu district, Uganda. OUTCOME MEASURES We describe the occurrence and care sought for fever and diarrhoea in the last 3 months by age group in the households. Care provider options included: CHE, health centre or clinic (public or private), pharmacy, drug shop and other. Geographic Information Ssystem (GIS)-based geographical measures were used to map all care providers around the active CHEs. RESULTS Fever and diarrhoea in the last 3 months occurred most frequently in children under 5; 68% and 41.9%, respectively. For those who sought care, CHE services were used for fever among children under 5, children 5-17 and adults over 18 years of age in 34.7%, 29.9% and 25.1%, respectively. For diarrhoea among children under 5, children 5-17 and adults over 18 years of age, CHE services were used in 22.1%, 19.5% and 7.0%, respectively. For those who did not seek care from a CHE (only), drug shops were most frequently used services for both fever and diarrhoea, followed by health centres or private clinics. Many households used a combination of services, which was possible given the high density and diversity of providers found in the study area. CONCLUSIONS CHEs play a considerable role in providing care in rural areas where they are active. The high density of informal drug shops and private clinics highlights the need for clarity on the de facto roles played by different providers in both the public and private sector to improve primary healthcare.
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Affiliation(s)
- Marinka van der Hoeven
- Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Monique van Lettow
- Department of Implementation and Operational Research, Madiro, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, Division of Epidemiology and Centre of Global Health, University of Toronto, Toronto, Ontario, Canada
| | - Pien Boonstra
- Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Raymond Tweheyo
- School of Public Health, Makerere University, Kampala, Uganda
| | - Maarten Olivier Kok
- Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
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Wijnhoven HAH, Kok AAL, Schaap LA, Hoekstra T, van Stralen MM, Twisk JWR, Visser M. The associations between sleep quality, mood, pain and appetite in community dwelling older adults: a daily experience study. J Nutr Health Aging 2024; 28:100028. [PMID: 38388106 DOI: 10.1016/j.jnha.2023.100028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/29/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVES To investigate the daily life experiences of sleep, mood, and pain in relation to appetite in community-dwelling older adults aged 75 years and older, stratified by sex. DESIGN Existing data from a daily experience study embedded in the Longitudinal Aging Study Amsterdam (LASA) among the oldest-old (≥75 years). SETTING LASA is an ongoing cohort study of a nationally representative sample of older adults aged ≥55 years from three culturally distinct regions in the Netherlands. PARTICIPANTS 434 community-dwelling older adults aged ≥75 years. MEASUREMENTS Participants filled-out a one-week diary on daily experience of pain, mood, last night sleep (10-point Likert scale), and appetite (5-point Likert scale) on five measurement occasions between 2016 and 2021. (Hybrid) linear mixed models were used to investigate overall, within-subject and between-subject association between mood, sleep, and pain (independent variables) and appetite (dependent variable), while correcting between-subject associations for season, age, educational level, partner status, body mass index, alcohol consumption, physical activity level, smoking status, chronic diseases and use of nervous system medication, stratified by sex. RESULTS Averaged over all days, males reported a poor appetite on 12% of the days and females on 19% of the days. Statistically significant between-subject associations with a poorer appetite were found for lower mood (unstandardized b = 0.084 [95% CI 0.043-0.126] (males), (b = 0.126 [95% CI 0.082-0.170] (females)), poorer sleep (b = 0.045 [95% CI 0.007-0.083] (males), (b = 0.51 [95% CI 0.017-0.085] (females)) and more severe pain in males only (b = 0.026 [95% CI 0.002-0.051]). Except for pain, within-subject associations were somewhat weaker: mood: b = 0.038 [95% CI 0.016-0.060] (males), (b = 0.082 [95% CI 0.061-0.104] (females)); sleep: b = 0.029 [95% CI 0.008-0.050] (males), (b = 0.15 [95% CI 0.005-0.025] (females)); and pain (b = 0.032 [95% CI 0.004-0.059] (males)). CONCLUSIONS This study found that poor sleep, low mood (more strongly in females) and more severe pain (males only) are associated with poor appetite in older adults on a daily level both within and between persons. Sex differences in factors related to poor appetite should be considered in future research.
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Affiliation(s)
- Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Almar A L Kok
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Methodology Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, Amsterdam Public Health Research Institute, Aging & Later Life Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Methodology Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Grøndahl LK, Axén I, Stensrud S, Hoekstra T, Vigdal ØN, Killingmo RM, Storheim K, Grotle M. Identifying latent subgroups in the older population seeking primary health care for a new episode of back pain - findings from the BACE-N cohort. BMC Musculoskelet Disord 2024; 25:60. [PMID: 38216905 PMCID: PMC10787445 DOI: 10.1186/s12891-024-07163-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/01/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Back pain is the number one condition contributing to years lived with disability worldwide, and one of the most common reasons for seeking primary care. Research on this condition in the ageing population is sparse. Further, the heterogeneity of patients with back pain complicates the management in clinical care. It is possible that subgrouping people with similar characteristics would improve management. This paper aimed to identify latent classes based on demographics, pain characteristics, psychosocial behavior, and beliefs and attitudes about back pain, among older patients seeking primary care with a new episode of back pain, and to examine if there were differences regarding the classes' first point-of-contact. METHODS The study was part of the international BACE (Back complaints in elders) consortium and included 435 patients aged ≥ 55 years seeking primary care (general practitioners, physiotherapists, and chiropractors) in Norway from April 2015 to March 2020. A latent class analysis was performed to identify latent classes. The classes were described in terms of baseline characteristics and first point-of-contact in primary care. RESULTS Four latent classes were identified. The mean age was similar across groups, as were high expectations towards improvement. Class 1 (n = 169, 39%), the "positive" class, had more positive attitudes and beliefs, less pain catastrophizing and shorter duration of current pain episode. Class 2 (n = 31, 7%), the "fearful" class, exhibited the most fear avoidance behavior, and had higher mean pain intensity. Class 3 (n = 33, 8%), the "distressed" class, had the highest scores on depression, disability, and catastrophizing. Finally, class 4 (n = 202, 46%), the "hopeful" class, showed the highest expectations for recovery, although having high pain intensity. The identified four classes showed high internal homogeneity, sufficient between-group heterogeneity and were considered clinically meaningful. The distribution of first point-of-contact was similar across classes, except for the positive class where significantly more patients visited chiropractors compared to general practitioners and physiotherapists. CONCLUSIONS The identified classes may contribute to targeting clinical management of these patients. Longitudinal research on these latent classes is needed to explore whether the latent classes have prognostic value. Validation studies are needed to evaluate external validity. TRIAL REGISTRATION Clinicaltrials.gov NCT04261309.
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Affiliation(s)
- Lise Kretz Grøndahl
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway.
- Et Liv i Bevegelse, the Norwegian Chiropractors' Research Foundation, Oslo, Norway.
| | - Iben Axén
- Et Liv i Bevegelse, the Norwegian Chiropractors' Research Foundation, Oslo, Norway
- Unit of Intervention and Implementation for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Silje Stensrud
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ørjan Nesse Vigdal
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Rikke Munk Killingmo
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Kjersti Storheim
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo, Norway
| | - Margreth Grotle
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo, Norway
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Lutomski JE, Hoekstra T, Akker MVD, Blom J, Calderón-Larrañaga A, Marengoni A, Prados-Torres A, Olde-Rikkert M, Melis R. Multimorbidity patterns in older persons and their association with self-reported quality of life and limitations in activities of daily living. Arch Gerontol Geriatr 2023; 115:105134. [PMID: 37516060 DOI: 10.1016/j.archger.2023.105134] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/12/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND As populations age, multimorbidity (the presence of two or more chronic morbidities) is increasingly more common. These evolving demographics demand further research into the identification of morbidity patterns in different settings as well as the longitudinal effects of these patterns. METHODS Prospectively collected data on 12,755 older persons aged 65+ years were derived from The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS, www.topics-mds.eu). Latent class analyses were performed to identify unobserved relationship patterns between morbidities in older persons. Using linear mixed models, the average difference in health-related quality of life (EQ-5D) and general quality of life scores (Cantril's Self Anchoring Ladder) as well as limitations in Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL) were examined over a 12-month period. RESULTS Five multimorbidity patterns were identified: sensory (n = 3882), cardio-metabolic (n = 2627), mental health (n = 920), osteo-articular (n = 4486), and system decline (n = 840). Relative to older persons in the sensory group, multimorbidity patterns did not have a strong effect on health-related quality of life, general quality of life or ADL/IADLs over a one-year period. CONCLUSIONS The observed multimorbidity patterns are similar to others based on different methodologies and study populations. When examining the effect of such patterns on quality of life, the EQ-5D and Cantril's Ladder may be insufficient outcome measures. Further investigations into the prognostic value of morbidity patterns would be of benefit.
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Affiliation(s)
- Jennifer E Lutomski
- Radboud Biobank, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands
| | - Marjan van den Akker
- Goethe University Frankfurt, Institute of General Practice, Frankfurt am Main, Germany; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, the Netherlands; Department of General Practice, Catholic University of Leuven, Belgium
| | - Jeanet Blom
- Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands
| | - Amaia Calderón-Larrañaga
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, REDISSEC-ISCIII, Spain; Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Aging Research Center, NVS Department - Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Alexandra Prados-Torres
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, REDISSEC-ISCIII, Spain
| | - Marcel Olde-Rikkert
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rene Melis
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
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Jacobi M, van der Schuur L, Seves BL, Brandenbarg P, Dekker R, Hettinga FJ, Hoekstra F, Krops LA, van der Woude LHV, Hoekstra T. Exploring experiences of people with stroke and health professionals on post-stroke fatigue guidance: getting the right people to the right care at the right time. Disabil Rehabil 2023:1-9. [PMID: 37950406 DOI: 10.1080/09638288.2023.2277398] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE This focus group study aimed to explore experiences and perceptions on post-stroke fatigue guidance in Dutch rehabilitation and follow-up care among people/patients with stroke and health professionals. METHODS Ten persons with stroke and twelve health professionals with different professions within stroke rehabilitation or follow-up care in the Netherlands were purposively sampled and included. Eight online focus group interviews were conducted. We analysed the data using reflexive thematic analysis. RESULTS Three themes were identified. Guidance in fatigue management did not always match the needs of people/patients with stroke. Professionals were positive about the provided fatigue guidance (e.g. advice on activity pacing), but found it could be better tailored to the situation of people/patients with stroke. Professionals believe the right time for post-stroke fatigue guidance is when people/patients with stroke are motivated to change physical activity behaviour to manage fatigue - mostly several months after stroke - while people/patients with stroke preferred information on post-stroke fatigue well before discharge. Follow-up care and suggestions for improvement described that follow-up support after rehabilitation by a stroke coach is not implemented nationwide, while people/patients with stroke and professionals expressed a need for it. CONCLUSIONS The study findings will help guide improvement of fatigue guidance in stroke rehabilitation programmes and stroke follow-up care aiming to improve physical activity, functioning, participation, and health.
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Affiliation(s)
- M Jacobi
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L van der Schuur
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - B L Seves
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - P Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - F J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - F Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - L A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - L H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - T Hoekstra
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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van Veen M, Schelvis RM, Hoekstra T, Bongers PM, Boot CR, Oude Hengel KM. Work characteristics and emotional exhaustion among young workers: a latent class analysis. BMJ Open 2023; 13:e074386. [PMID: 37852771 PMCID: PMC10603524 DOI: 10.1136/bmjopen-2023-074386] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/27/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVES This study aims to assess the heterogeneity of psychosocial working conditions of young workers by identifying subgroups of work characteristic configurations within young workers and to assess these subgroups' associations with emotional exhaustion. DESIGN Latent class analysis. Groups were formed based on 12 work characteristics (8 job demands and 4 job resources), educational level and sex. Differences in emotional exhaustion between subgroups were analysed using analysis of variance and post hoc comparisons. SETTING Data from the 2019 wave of the Netherlands Working Conditions Survey. PARTICIPANTS 7301 individuals between the age of 18 and 30 years, who worked more than 16 hours per week. MAIN OUTCOME MEASURE Emotional exhaustion. RESULTS Five subgroups of work characteristics could be identified and were labelled as: (1) 'low-complexity work' (24.4%), (2) 'office work' (32.3%), (3) 'manual and non-interpersonal work' (12.4%), (4) 'non-manual and interpersonal work' (21.0%), and (5) 'manual and interpersonal work' (9.9%). Mean scores for emotional exhaustion in the two interpersonal work groups (M=3.11, SD=1.4; M=3.45, SD=1.6) were significantly higher than in the first three groups (M=2.05, SD=1.1; M=1.98, SD=1.0; M=2.05, SD=1.1) (all 95% CIs excluding 0). Further, mean scores for emotional exhaustion were significantly higher in the 'manual and interpersonal work' group than in the 'non-manual and interpersonal work' group (95% CI 0.24, 0.45). All results could be replicated in the 2017 and 2021 waves of the Netherlands Working Conditions Survey. CONCLUSIONS Young workers reported heterogeneous work characteristic configurations with substantial differences in degrees of emotional exhaustion between the identified subgroups. Preventing emotional exhaustion should focus on the two interpersonal work subgroups, which showed a high degree of emotional exhaustion. In prevention efforts, these groups' configurations of work characteristics should be taken into account.
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Affiliation(s)
- Malte van Veen
- Amsterdam Public Health, Societal Participation & Health, Amsterdam UMC, Amsterdam, The Netherlands
- Unit Healthy Living & Work, TNO Location Leiden Sylviusweg, Leiden, The Netherlands
- Body@Work, Amsterdam, The Netherlands
- Public and Occupational Health, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | - Roosmarijn Mc Schelvis
- Amsterdam Public Health, Societal Participation & Health, Amsterdam UMC, Amsterdam, The Netherlands
- Body@Work, Amsterdam, The Netherlands
- Public and Occupational Health, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - Paulien M Bongers
- Unit Healthy Living & Work, TNO Location Leiden Sylviusweg, Leiden, The Netherlands
- Body@Work, Amsterdam, The Netherlands
- Public and Occupational Health, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | - Cécile Rl Boot
- Amsterdam Public Health, Societal Participation & Health, Amsterdam UMC, Amsterdam, The Netherlands
- Body@Work, Amsterdam, The Netherlands
- Public and Occupational Health, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | - Karen M Oude Hengel
- Unit Healthy Living & Work, TNO Location Leiden Sylviusweg, Leiden, The Netherlands
- Body@Work, Amsterdam, The Netherlands
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Brandenbarg P, Hoekstra F, Barakou I, Seves BL, Hettinga FJ, Hoekstra T, van der Woude LHV, Dekker R, Krops LA. Measurement properties of device-based physical activity instruments in ambulatory adults with physical disabilities and/or chronic diseases: a scoping review. BMC Sports Sci Med Rehabil 2023; 15:115. [PMID: 37735403 PMCID: PMC10512652 DOI: 10.1186/s13102-023-00717-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/22/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND People with physical disabilities and/or chronic diseases tend to have an inactive lifestyle. Monitoring physical activity levels is important to provide insight on how much and what types of activities people with physical disabilities and/or chronic diseases engage in. This information can be used as input for interventions to promote a physically active lifestyle. Therefore, valid and reliable physical activity measurement instruments are needed. This scoping review aims 1) to provide a critical mapping of the existing literature and 2) directions for future research on measurement properties of device-based instruments assessing physical activity behavior in ambulant adults with physical disabilities and/or chronic diseases. METHODS Four databases (MEDLINE, CINAHL, Web of Science, Embase) were systematically searched from 2015 to April 16th 2023 for articles investigating measurement properties of device-based instruments assessing physical activity in ambulatory adults with physical disabilities and/or chronic diseases. For the majority, screening and selection of eligible studies were done in duplicate. Extracted data were publication data, study data, study population, device, studied measurement properties and study outcome. Data were synthesized per device. RESULTS One hundred three of 21566 Studies were included. 55 Consumer-grade and 23 research-grade devices were studied on measurement properties, using 14 different physical activity outcomes, in 23 different physical disabilities and/or chronic diseases. ActiGraph (n = 28) and Fitbit (n = 39) devices were most frequently studied. Steps (n = 68) was the most common used physical activity outcome. 97 studies determined validity, 11 studies reliability and 6 studies responsiveness. CONCLUSION This scoping review shows a large variability in research on measurement properties of device-based instruments in ambulatory adults with physical disabilities and/or chronic diseases. The variability highlights a need for standardization of and consensus on research in this field. The review provides directions for future research.
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Affiliation(s)
- Pim Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands.
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands.
| | - Femke Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, V1V 1V7, Canada
| | - Ioulia Barakou
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Bregje L Seves
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, NE1 8ST, UK
| | - Trynke Hoekstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, 1081 BT, The Netherlands
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Rienk Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Leonie A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
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Walburg FS, van Meijel B, Hoekstra T, Kol J, Pape LM, de Joode JW, van Tulder M, Adriaanse M. Effectiveness of a Lifestyle Intervention for People With a Severe Mental Illness in Dutch Outpatient Mental Health Care: A Randomized Clinical Trial. JAMA Psychiatry 2023; 80:886-894. [PMID: 37342055 PMCID: PMC10285675 DOI: 10.1001/jamapsychiatry.2023.1566] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/22/2023] [Indexed: 06/22/2023]
Abstract
Importance People with a severe mental illness (SMI) have a life expectancy reduced by 10 to 20 years compared with the general population, primarily attributable to cardiometabolic disorders. Lifestyle interventions for people with SMI can improve health and reduce cardiometabolic risk. Objective To evaluate the effectiveness of a group-based lifestyle intervention among people with SMI in outpatient treatment settings compared with treatment as usual (TAU). Design, Setting, and Participants The Severe Mental Illness Lifestyle Evaluation (SMILE) study is a pragmatic cluster randomized clinical trial performed in 8 mental health care centers with 21 flexible assertive community treatment teams in the Netherlands. Inclusion criteria were SMI, age of 18 years or older, and body mass index (calculated as weight in kilograms divided by height in meters squared) of 27 or greater. Data were collected from January 2018 to February 2020, and data were analyzed from September 2020 to February 2023. Interventions Weekly 2-hour group sessions for 6 months followed by monthly 2-hour group sessions for another 6 months, delivered by trained mental health care workers. The intervention targeted overall lifestyle changes, emphasizing establishing a healthy diet and promoting physical activity. TAU (control) did not include structured interventions or advice on lifestyle. Main Outcomes and Measures Crude and adjusted linear mixed models and multivariable logistic regression analyses were performed. The main outcome was body weight change. Secondary outcomes included changes in body mass index, blood pressure, lipid profiles, fasting glucose level, quality of life, self-management ability, and lifestyle behaviors (physical activity and health, mental health, nutrition, and sleep). Results The study population included 11 lifestyle intervention teams (126 participants) and 10 TAU teams (98 participants). Of 224 included patients, 137 (61.2%) were female, and the mean (SD) age was 47.6 (11.1) years. From baseline to 12 months, participants in the lifestyle intervention group lost 3.3 kg (95% CI, -6.2 to -0.4) more than those in the control group. In the lifestyle intervention group, people with high attendance rates lost more weight than participants with medium and low rates (mean [SD] weight loss: high, -4.9 [8.1] kg; medium, -0.2 [7.8] kg; low, 0.8 [8.3] kg). Only small or no changes were found for secondary outcomes. Conclusions and Relevance In this trial, the lifestyle intervention significantly reduced weight from baseline to 12 months in overweight and obese adults with SMI. Tailoring lifestyle interventions and increasing attendance rates might be beneficial for people with SMI. Trial Registration Netherlands Trial Register Identifier: NTR6837.
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Affiliation(s)
- Florine Sanna Walburg
- Department Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Berno van Meijel
- Inholland University of Applied Sciences, Department of Health, Sports and Welfare, Mental Health Nursing Research Group, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC (VUmc), Amsterdam, the Netherlands
- Parnassia Psychiatric Institute, Parnassia Academy, The Hague, the Netherlands
| | - Trynke Hoekstra
- Department Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Jelle Kol
- Department Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Laura Michelle Pape
- Department Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Johanna Willemina de Joode
- Department Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Maurits van Tulder
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marcel Adriaanse
- Department Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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Brandenbarg P, Krops LA, Seves BL, Hoekstra T, Hettinga FJ, Twisk JWR, van der Woude LHV, Dekker R, Hoekstra F. Psychosocial factors of physical activity among people with disabilities: Prospective cohort study. Rehabil Psychol 2023; 68:164-173. [PMID: 36780269 DOI: 10.1037/rep0000488] [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: 02/14/2023]
Abstract
PURPOSE/OBJECTIVE This study aimed to (a) explore the associations between psychosocial factors and physical activity behavior in people with physical disabilities and/or chronic diseases, both between and within persons over time; and (b) examine whether these associations differ for people initiating and people maintaining physical activity behavior. RESEARCH METHOD/DESIGN Data of 1,256 adults with physical disabilities and/or chronic diseases enrolled in the prospective cohort study Rehabilitation, Sports, and Active lifestyle (ReSpAct) were analyzed. Self-reported physical activity and four main psychosocial factors (i.e., self-efficacy, attitude, motivation, social support) were measured with questionnaires 3-6 weeks before discharge (T0) and 14 (T1), 33 (T2), and 52 (T3) weeks after discharge from rehabilitation. Hybrid multilevel regression models (corrected for age, sex, education level, diagnosis, counseling support) were used. RESULTS Multivariable significant between-subject associations were found for self-efficacy (std β = .094; 95% CI [0.035, 0.153]) and intrinsic motivation (std β = .114; [0.036, 0.192]). Multivariable significant within-subject associations were found for identified regulation (std β = -.038; [-0.072, -0.005]) and intrinsic motivation (std β = .049; [0.016, 0.082]). Effect modification of initiating or maintaining physical activity was found for the between-subject association of attitude (p = .035). No significant associations were found for social support, amotivation, external regulation, and introjected regulation. CONCLUSION/IMPLICATIONS This study is the first that explored the between- and within-subject associations between psychosocial factors and physical activity over time in a large cohort of adults with physical disabilities and/or chronic diseases. The findings indicate the importance of intrinsic motivation, identified regulation, and self-efficacy in initiating and maintaining physical activity behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Pim Brandenbarg
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen
| | - Leonie A Krops
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen
| | - Bregje L Seves
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen
| | - Trynke Hoekstra
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen
| | | | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen
| | - Rienk Dekker
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen
| | - Femke Hoekstra
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen
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11
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Küçükaksu MH, van Meijel B, Jansen L, Hoekstra T, Adriaanse MC. A smoking cessation intervention for people with severe mental illness treated in ambulatory mental health care (KISMET): study protocol of a randomised controlled trial. BMC Psychiatry 2023; 23:108. [PMID: 36797709 PMCID: PMC9933801 DOI: 10.1186/s12888-023-04599-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Smoking among people with severe mental illness (SMI) is highly prevalent and strongly associated with poor physical health. Currently, evidence-based smoking cessation interventions are scarce and need to be integrated into current mental health care treatment guidelines and clinical practice. Therefore, the present study aims to evaluate the implementation and effectiveness of a smoking cessation intervention in comparison with usual care in people with SMI treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands. METHODS A pragmatic, cluster-randomised controlled trial with embedded process evaluation will be conducted. Randomisation will be performed at the level of FACT teams, which will be assigned to the KISMET intervention or a control group (care as usual). The intervention will include pharmacological treatment combined with behavioural counselling and peer support provided by trained mental health care professionals. The intervention was developed using a Delphi study, through which a consensus was reached on the core elements of the intervention. We aim to include a total of 318 people with SMI (aged 18-65 years) who smoke and desire to quit smoking. The primary outcome is smoking status, as verified by carbon monoxide measurements and self-report. The secondary outcomes are depression and anxiety, psychotic symptoms, physical fitness, cardiovascular risks, substance use, quality of life, and health-related self-efficacy at 12 months. Alongside the trial, a qualitative process evaluation will be conducted to evaluate the barriers to and facilitators of its implementation as well as the satisfaction and experiences of both patients and mental health care professionals. DISCUSSION The results of the KISMET trial will contribute to the evidence gap of effective smoking cessation interventions for people treated by FACT teams. Moreover, insights will be obtained regarding the implementation process of the intervention in current mental health care. The outcomes should advance the understanding of the interdependence of physical and mental health and the gradual integration of both within the mental health care system. TRIAL REGISTRATION Netherlands Trial Register, NTR9783. Registered on 18 October 2021.
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Affiliation(s)
- Müge H. Küçükaksu
- grid.12380.380000 0004 1754 9227Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Science, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - Berno van Meijel
- grid.16872.3a0000 0004 0435 165XDepartment of Psychiatry, Amsterdam UMC and Amsterdam Public Health research institute, Amsterdam, Netherlands ,grid.448984.d0000 0003 9872 5642Department of Health, Sports & Welfare, Inholland University of Applied Sciences, De Boelelaan 1109, 1081HV Amsterdam, The Netherlands ,grid.476585.d0000 0004 0447 7260Parnassia Psychiatric Institute, The Hague, Netherlands
| | - Lola Jansen
- grid.12380.380000 0004 1754 9227Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Science, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- grid.12380.380000 0004 1754 9227Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Science, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - Marcel C. Adriaanse
- grid.12380.380000 0004 1754 9227Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Science, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
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12
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Roordink EM, Steenhuis IHM, Kroeze W, Hoekstra T, Jacobs N, van Stralen MM. Social Environmental Predictors of Lapse in Dietary Behavior: An Ecological Momentary Assessment Study Amongst Dutch Adults Trying to Lose Weight. Ann Behav Med 2023:7000437. [PMID: 36694372 PMCID: PMC10354841 DOI: 10.1093/abm/kaac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND When losing weight, most individuals find it difficult to maintain a healthy diet. Social environmental conditions are of pivotal importance in determining dietary behavior. To prevent individuals from lapsing, insight in social environmental predictors of lapse in dietary behavior is needed. PURPOSE Identify social environmental predictors of lapse in dietary behavior, using ecological momentary assessment (EMA) amongst Dutch adults trying to lose weight. METHODS Adults (N = 81) participated in two 7-day EMA weeks. Six times a day semi-random prompts were sent. At each prompt, participants indicated whether a lapse had occurred and responded to questions assessing social support, descriptive norm, injunctive norm, social pressure, presence of others, and current location. Generalized estimating equations were used to examine associations with lapse. RESULTS Injunctive norm (OR = 1.07, 95% CI = 1.03-1.11), descriptive norm (OR = 1.04, 95% CI = 1.02-1.07), and social pressure (OR = 1.09, 95% CI = 1.05-1.14), all toward diverting from diet plans, predicted lapses. Social support toward sticking to diet plans and presence of others did not predict lapses. When controlling for a prior lapse, all other associations became nonsignificant. Lapses occurred most often at home and gradually occurred more often during the day. CONCLUSIONS Traditional public health perspectives have mainly focused on individual choice and responsibility for overweight related unhealthy lifestyles. This study shows that there may be opportunities to enhance intervention programs by also focusing on social norms and social pressure. The involvement of partners or housemates may create more awareness of the impact of (unintentional) social pressure on risk of lapsing, and reduce the level of exerted social pressure.
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Affiliation(s)
- Eline M Roordink
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.,Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS Ede, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Nele Jacobs
- Department of Lifespan Psychology, Faculty of Psychology, Open Universiteit, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
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13
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Hartog J, Dijkstra S, Dieperink W, Hoekstra T, Fleer J, van der Woude LHV, van der Harst P, Nijsten M, Mariani MA, Blokzijl F. Muscle strength trajectories and their association with postoperative health-related quality of life in patients undergoing coronary artery bypass grafting surgery: a prospective cohort study. BMC Cardiovasc Disord 2023; 23:20. [PMID: 36646994 PMCID: PMC9841699 DOI: 10.1186/s12872-023-03056-7] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 01/11/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Patients with sarcopenia have a higher risk of poor recovery after coronary artery bypass grafting (CABG). Little is known about the impact of changes in muscle strength (the primary indicator for sarcopenia) on health-related quality of life (HR-QoL). This study aimed to (1) identify subgroups with different muscle strength trajectories, (2) identify differences in preoperative risk factors among trajectory group membership, and (3) explore their prognostic value on postoperative HR-QoL in patients undergoing CABG. METHODS In this prospective observational study 131 patients undergoing elective CABG completed grip strength tests and HR-QoL questionnaires. Latent Class Growth Mixture Modelling (LCGMM) was used to identify clinically relevant trajectories (> 5% of study population) for weight-normalised grip strength, measured at admission, 3 days, and 6 months after surgery. Differences between trajectory group membership at baseline were evaluated. The impact of trajectory group membership on postoperative HR-QoL was evaluated with multiple linear regression models. RESULTS Due to low numbers (n = 15), female patients were excluded from LCGMM and subsequent statistical analyses. In males (n = 116), we identified two main weight-normalised grip strength trajectories: a "stable average" trajectory with a slight decline immediately post-surgery and recovery to preoperative levels (n = 85) and a "high" trajectory with a considerable immediate decline after surgery but followed towards a higher level of recovery compared to preoperative level (n = 27). The "stable average" patients were older (68 vs. 57 years; P = 0.003), had more diabetes (27% vs. 4%; P = 0.01) and had a higher BMI (27.8 vs. 24.8; P = 0.005) compared to the "high" group. After correction for age, diabetes, and baseline HR-QoL, group trajectory membership was not associated with postoperative HR-QoL, yet an increase in individual change scores of weight-normalised grip strength was associated with a better postoperative HR-QoL. We also identified one small trajectory group (n = 4, ≤ 5%). CONCLUSIONS This study showed two relevant weight-normalised grip strength trajectories in male patients undergoing CABG, varying in important preoperative risk factors. While change scores of grip strength per weight did predict postoperative HR-QoL, the trajectory subgroups could not predict postoperative HR-QoL. Future research should focus on female patients, reacting potentially different on CABG and/or rehabilitation treatment. Trial registration NCT03774342, 12-12-2018.
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Affiliation(s)
- Johanneke Hartog
- grid.4830.f0000 0004 0407 1981Department of Cardiothoracic Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, AB41, 9713 GZ Groningen, The Netherlands
| | - Sandra Dijkstra
- grid.4830.f0000 0004 0407 1981Department of Cardiothoracic Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, AB41, 9713 GZ Groningen, The Netherlands
| | - Willem Dieperink
- grid.4494.d0000 0000 9558 4598Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands ,grid.411989.c0000 0000 8505 0496Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Trynke Hoekstra
- grid.12380.380000 0004 1754 9227Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Joke Fleer
- grid.4494.d0000 0000 9558 4598Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lucas H. V. van der Woude
- grid.4494.d0000 0000 9558 4598Department of Rehabilitation Medicine, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pim van der Harst
- grid.4494.d0000 0000 9558 4598Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands ,grid.7692.a0000000090126352Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten Nijsten
- grid.4494.d0000 0000 9558 4598Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Massimo A. Mariani
- grid.4830.f0000 0004 0407 1981Department of Cardiothoracic Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, AB41, 9713 GZ Groningen, The Netherlands
| | - Fredrike Blokzijl
- grid.4830.f0000 0004 0407 1981Department of Cardiothoracic Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, AB41, 9713 GZ Groningen, The Netherlands ,grid.411989.c0000 0000 8505 0496Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
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Willems SJ, Coppieters MW, Rooker S, Ostelo R, Hoekstra T, Scholten-Peeters GGM. Variability in recovery following microdiscectomy and postoperative physiotherapy for lumbar radiculopathy: A latent class trajectory analysis. Clin Neurol Neurosurg 2022; 224:107551. [PMID: 36563569 DOI: 10.1016/j.clineuro.2022.107551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The clinical course of lumbar radiculopathy following microdiscectomy and post-operative physiotherapy varies substantially. No prior studies assessed this variability by deriving outcome trajectories. The primary aims of this study were to evaluate the variability in long-term recovery after lumbar microdiscectomy followed by post-operative physiotherapy and to identify outcome trajectories. The secondary aim was to assess whether demographic, clinical characteristics and patient-reported outcome measures routinely collected at baseline could predict poor outcome trajectories. METHODS We conducted a prospective cohort study with a 24-month follow-up. We included 479 patients with clinical signs and symptoms of lumbar radiculopathy confirmed by Magnetic Resonance Imaging findings, who underwent microdiscectomy and post-operative physiotherapy. Outcomes were leg pain and back pain measured with Visual Analogue Scales, and disability measured with the Roland-Morris Disability Questionnaire. Descriptive statistics were performed to present the average and the individual clinical course. A latent class trajectory analysis was conducted to identify leg pain, back pain, and disability outcome trajectories. The best number of clusters was determined using the Bayesian Information Criterion, Akaike's information criteria, entropy, and overall interpretability. Prediction models for poor outcome trajectories were assessed using multivariable logistic regression analyses. RESULTS Several outcome trajectories were identified. Most patients were assigned to the 'large improvement' trajectory (leg pain: 79.3%; back pain: 70.2%; disability: 59.5% of patients). Smaller proportions of patients were assigned to the 'moderate improvement' trajectory (leg pain: 7.9%; back pain: 10.6%; disability: 20.7% of patients), the 'minimal improvement' trajectory (leg pain: 4.9%, back pain: 6.7%, disability: 16.3% of patients) and the 'relapse' trajectory (leg pain: 7.9%; back pain: 12.5%; disability: 3.5%). Approximately one-third of patients (32.6%) belonged to one or more than one poor outcome trajectory. Patients with previous treatment (prior back surgery, injection therapy, and medication use) and those who had higher baseline pain and disability scores were more likely to belong to the poor outcome trajectories in comparison to the large improvement trajectories in back pain, leg pain and disability, and the moderate improvement trajectory in disability. The explained variance (Nagelkerke R2) of the prediction models ranged from 0.06 to 0.13 and the discriminative ability (Area Under the Curve) from 0.66 to 0.73. CONCLUSION The clinical course of lumbar radiculopathy varied following microdiscectomy and post-operative physiotherapy, and several outcome trajectories could be identified. Although most patients were allocated to favorable trajectories, one in three patients was assigned to one or more poor outcome trajectories following microdiscectomy and post-operative physiotherapy for lumbar radiculopathy. Routinely gathered data were unable to predict the poor outcome trajectories accurately. Prior to surgery, clinicians should discuss the high variability and the distinctive subgroups that are present in the clinical course with their patients.
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Affiliation(s)
- Stijn J Willems
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - Michel W Coppieters
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Menzies Health Institute Queensland, Griffith University, Brisbane, Gold Coast, Australia; School of Health Sciences and Social Work, Griffith University, Brisbane, Gold Coast, Australia.
| | - Servan Rooker
- Department of Neurosurgery Kliniek ViaSana, Mill, the Netherlands; Department of Family medicine and population health (FAMPOP), University of Antwerp, Antwerp, Belgium.
| | - Raymond Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute,Amsterdam, the Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands.
| | - Trynke Hoekstra
- Department of Health Sciences and the Amsterdam Public Health Research Institute, Faculty of Science, Vrije Universiteit Amsterdam, the Netherlands.
| | - Gwendolyne G M Scholten-Peeters
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
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Barakou I, Seves BL, Hoekstra T, Hoekstra F, Krops L, Brandenbarg P, van der Woude LH, Dekker R, Hettinga FJ. Activity Pacing Patterns In Adults With Disabilities. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000878796.90698.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Brandenbarg P, Hoekstra F, Krops LA, Seves BL, Hettinga FJ, Hoekstra T, Dekker R, van der Woude LHV. Physical activity behaviour up to 1 year post-rehabilitation among adults with physical disabilities and/or chronic diseases: results of the prospective cohort study ReSpAct. BMJ Open 2022; 12:e056832. [PMID: 35705356 PMCID: PMC9204426 DOI: 10.1136/bmjopen-2021-056832] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Little is known of physical activity behaviour among adults with a disability and/or chronic disease during and up to 1 year post-rehabilitation. We aimed to explore (1) dose characteristics of physical activity behaviour among adults with physical disabilities and/or chronic diseases during that period, and (2) the effects of personal characteristics and diagnosis on the development of physical activity over time. METHODS Adults with physical disabilities and/or chronic diseases (N=1256), enrolled in the Rehabilitation, Sports and Active lifestyle study, were followed with questionnaires: 3-6 weeks before (T0) and 14 (T1), 33 (T2) and 52 (T3) weeks after discharge from rehabilitation. Physical activity was assessed with the adapted version of the Short Questionnaire to ASsess Health enhancing physical activity. Dose characteristics of physical activity were descriptively analysed. Multilevel regression models were performed to assess physical activity over time and the effect of personal and diagnosis characteristics on physical activity over time. RESULTS Median total physical activity ranged from 1545 (IQR: 853-2453) at T0 to 1710 (IQR: 960-2730) at T3 min/week. Household (495-600 min/week) and light-intensity (900-998 min/week) activities accrued the most minutes. Analyses showed a significant increase in total physical activity moderate-intensity to vigorous-intensity physical activity and work/commuting physical activity for all time points (T1-T3) compared with baseline (T0). Diagnosis, age, sex and body mass index had a significant effect on baseline total physical activity. CONCLUSION Physical activity is highly diverse among adults with physical disabilities and/or chronic diseases. Understanding this diversity in physical activity can help improve physical activity promotion activities.
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Affiliation(s)
- Pim Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Femke Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Leonie A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bregje L Seves
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Trynke Hoekstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rienk Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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17
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Voorwinde V, Hoekstra T, Monpellier V, Steenhuis I, Janssen I, van Stralen M. Five-year weight loss, physical activity, and eating style trajectories following bariatric surgery. Surg Obes Relat Dis 2022; 18:911-918. [DOI: 10.1016/j.soard.2022.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/11/2022] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
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18
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Bonenkamp AA, Vonk S, Abrahams AC, Vermeeren YM, van Eck van der Sluijs A, Hoekstra T, van Ittersum FJ, van Jaarsveld BC, Korte MR, Cnossen TT, Jaarsveld BC, Krepel HP, Dam MAGJ, Doorenbos CJ, Özyilmaz A, Boereboom FTJ, Esch S, Breda GF, Hoorn EJ, Severs D, Boonstra AH, Nette RW, Vermeeren YM, Thang HD, Hommes NH, Buren M, Hofstra JM, Diepeveen SHA, Boorsma S, Rotmans JI, Sande F, Litjens EJR, Brink HS, Wijering R, Hagen EC, Penne EL, Fijter CWH, Brulez HFH, Hamersvelt HW, Huisman SJ, Douma CE, Abrahams AC, Luik AJ, Klaassen RJL, Weenink AG, Krekels MME. Comorbidity is not associated with dialysis modality choice in patients with end‐stage kidney disease. Nephrology (Carlton) 2022; 27:510-518. [PMID: 35244316 PMCID: PMC9315144 DOI: 10.1111/nep.14033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Anna A. Bonenkamp
- Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam Research institute Amsterdam Cardiovascular Sciences Amsterdam the Netherlands
| | - Sanne Vonk
- Department of Nephrology and Hypertension University Medical Centre Utrecht Utrecht the Netherlands
| | - Alferso C. Abrahams
- Department of Nephrology and Hypertension University Medical Centre Utrecht Utrecht the Netherlands
| | | | | | - T. Hoekstra
- Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam Research institute Amsterdam Cardiovascular Sciences Amsterdam the Netherlands
| | - Frans J. van Ittersum
- Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam Research institute Amsterdam Cardiovascular Sciences Amsterdam the Netherlands
| | - Brigit C. van Jaarsveld
- Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam Research institute Amsterdam Cardiovascular Sciences Amsterdam the Netherlands
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19
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Küçükaksu MH, Hoekstra T, Jansen L, Vermeulen J, Adriaanse MC, van Meijel B. Developing a Smoking Cessation Intervention for People With Severe Mental Illness Treated by Flexible Assertive Community Treatment Teams in the Netherlands: A Delphi Study. Front Psychiatry 2022; 13:866779. [PMID: 35873255 PMCID: PMC9301140 DOI: 10.3389/fpsyt.2022.866779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/16/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is still limited evidence on the effectiveness and implementation of smoking cessation interventions for people with severe mental illness (SMI) in Dutch outpatient psychiatric settings. The present study aimed to establish expert consensus on the core components and strategies to optimise practical implementation of a smoking cessation intervention for people treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands. DESIGN A modified Delphi method was applied to reach consensus on three core components (behavioural counselling, pharmacological treatment and peer support) of the intervention. The Delphi panel comprised five experts with different professional backgrounds. We proposed a first intervention concept. The panel critically examined the evolving concept in three iterative rounds of 90 min each. Responses were recorded, transcribed verbatim and thematically analysed. RESULTS Overall, results yielded that behavioural counselling should focus on preparation for smoking cessation, guidance, relapse prevention and normalisation. Pharmacological treatment consisting of nicotine replacement therapy (NRT), Varenicline or Bupropion, under supervision of a psychiatrist, was recommended. The panel agreed on integrating peer support as a regular part of the intervention, thus fostering emotional and practical support among patients. Treatment of a co-morbid cannabis use disorder needs to be integrated into the intervention if indicated. Regarding implementation, staff's motivation to support smoking cessation was considered essential. For each ambulatory team, two mental health care professionals will have a central role in delivering the intervention. CONCLUSIONS This study provides insight into expert consensus on the core components of a smoking cessation intervention for people with SMI. The results of this study were used for the development of a comprehensive smoking cessation program.
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Affiliation(s)
- Müge H Küçükaksu
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lola Jansen
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jentien Vermeulen
- Department of Psychiatry, Amsterdam University Medical Centre (UMC), University of Amsterdam, Amsterdam, Netherlands
| | - Marcel C Adriaanse
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Berno van Meijel
- Department of Psychiatry, Amsterdam University Medical Centre (UMC) and Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Department of Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, Netherlands.,Parnassia Psychiatric Institute, Parnassia Academy, The Hague, Netherlands
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20
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Noorland SA, Hoekstra T, Kok MO. The experiences and needs of re-entering nurses during the COVID-19 pandemic: A qualitative study. Int J Nurs Stud Adv 2021; 3:100043. [PMID: 34661169 PMCID: PMC8501512 DOI: 10.1016/j.ijnsa.2021.100043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022] Open
Abstract
Background: During the COVID-19 outbreak in the Netherlands, thousands of former nurses have returned to nursing to support healthcare staff. After a period of absence and with little time to prepare, these former nurses re-entered during a challenging, uncertain and rapidly evolving pandemic. Little is known about the experiences and needs of these re-entering nurses. Objectives: Assessing the needs and experiences of re-entering nurses during the COVID-19 pandemic. Design: Qualitative study using a pragmatist approach within the interpretative paradigm. Settings: This study took place in the following settings within the Dutch healthcare system: Intensive care units, COVID and regular departments within hospitals, nursing home settings, a rehabilitation centre and newly established COVID-19 departments within nursing home settings. Participants: We purposively selected 20 nurses who had re-entered nursing during the first wave of the COVID-19 pandemic between March 2020 and June 2020 in the Netherlands. The first interview was conducted on the eighth of May 2020. Methods: We conducted 20 semi-structured interviews in Dutch. Interviews were transcribed verbatim and analysed via thematic content analysis in the coding program of MAXQDA2020. This study followed the SRQR and COREQ guidelines. Results: Seven main themes were identified. Clear job description: Participants mentioned that a lack of a clear job description led to lack of clarity about the kind of tasks that re-entering nurses were expected and allowed to perform. Training: the majority of the participants had received none or little training prior to their return. Training content: Re-entering nurses mentioned to wish for an easily accessible mentorship structure and an individualised and practical training program. Positive team dynamic: Re-entering nurses felt supported by a positive team dynamic, which was shaped by the sense of urgency and relevance of their work and helped them deal with stressful experiences. Mental health: Nearly all participants mentioned that re-entering during a pandemic did not lead to impairment of their mental health. mental health support: Most participants mentioned being able to cope with their mental health independently, sharing experiences with family and colleagues Conclusion: The results indicate that a rapid and safe return to nursing during a pandemic could be facilitated by: a clear description of roles and responsibilities; an individualised assessment determining the competences and knowledge disparities of re-entering nurses; practical training focussing on competencies needed during a pandemic; and a collaborative mentorship structure to guide re-entering nurses. Tweetable abstract: In-depth interviews with former nurses who returned to #nursing during the first wave of the #COVID19 #pandemic in the Netherlands
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Affiliation(s)
- Sofie A Noorland
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam 3062 PA, the Netherlands.,Department of Health Sciences and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam 1081 HV, the Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam 1081 HV, the Netherlands
| | - Maarten O Kok
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam 3062 PA, the Netherlands.,Department of Health Sciences and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam 1081 HV, the Netherlands
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21
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Stunt J, van Grootel L, Bouter L, Trafimow D, Hoekstra T, de Boer M. Why we habitually engage in null-hypothesis significance testing: A qualitative study. PLoS One 2021; 16:e0258330. [PMID: 34653185 PMCID: PMC8519469 DOI: 10.1371/journal.pone.0258330] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 09/24/2021] [Indexed: 11/28/2022] Open
Abstract
Background Null Hypothesis Significance Testing (NHST) is the most familiar statistical procedure for making inferences about population effects. Important problems associated with this method have been addressed and various alternatives that overcome these problems have been developed. Despite its many well-documented drawbacks, NHST remains the prevailing method for drawing conclusions from data. Reasons for this have been insufficiently investigated. Therefore, the aim of our study was to explore the perceived barriers and facilitators related to the use of NHST and alternative statistical procedures among relevant stakeholders in the scientific system. Methods Individual semi-structured interviews and focus groups were conducted with junior and senior researchers, lecturers in statistics, editors of scientific journals and program leaders of funding agencies. During the focus groups, important themes that emerged from the interviews were discussed. Data analysis was performed using the constant comparison method, allowing emerging (sub)themes to be fully explored. A theory substantiating the prevailing use of NHST was developed based on the main themes and subthemes we identified. Results Twenty-nine interviews and six focus groups were conducted. Several interrelated facilitators and barriers associated with the use of NHST and alternative statistical procedures were identified. These factors were subsumed under three main themes: the scientific climate, scientific duty, and reactivity. As a result of the factors, most participants feel dependent in their actions upon others, have become reactive, and await action and initiatives from others. This may explain why NHST is still the standard and ubiquitously used by almost everyone involved. Conclusion Our findings demonstrate how perceived barriers to shift away from NHST set a high threshold for actual behavioral change and create a circle of interdependency between stakeholders. By taking small steps it should be possible to decrease the scientific community’s strong dependence on NHST and p-values.
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Affiliation(s)
- Jonah Stunt
- Department of Health Sciences, Section of Methodology and Applied Statistics, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
- * E-mail:
| | - Leonie van Grootel
- Department of Health Sciences, Section of Methodology and Applied Statistics, Vrije Universiteit, Amsterdam, The Netherlands
- Rathenau Institute, The Hague, The Netherlands
| | - Lex Bouter
- Department of Philosophy, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - David Trafimow
- Psychology Department, New Mexico State University, Las Cruces, New Mexico, United States of America
| | - Trynke Hoekstra
- Department of Health Sciences, Section of Methodology and Applied Statistics, Vrije Universiteit, Amsterdam, The Netherlands
| | - Michiel de Boer
- Department of Health Sciences, Section of Methodology and Applied Statistics, Vrije Universiteit, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care, University Medical Center Groningen, Groningen, The Netherlands
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22
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Pratiwi AB, Setiyaningsih H, Kok MO, Hoekstra T, Mukti AG, Pisani E. Is Indonesia achieving universal health coverage? Secondary analysis of national data on insurance coverage, health spending and service availability. BMJ Open 2021; 11:e050565. [PMID: 34607864 PMCID: PMC8491299 DOI: 10.1136/bmjopen-2021-050565] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To analyse the relationship between health need, insurance coverage, health service availability, service use, insurance claims and out-of-pocket spending on health across Indonesia. DESIGN Secondary analysis of nationally representative quantitative data. We merged four national data sets: the National Socioeconomic Survey 2018, National Census of Villages 2018, Population Health Development Index 2018 and National Insurance Records to end 2017. Descriptive analysis and linear regression were performed. SETTING Indonesia has one of the world's largest single-payer national health insurance schemes. Data are individual and district level; all are representative for each of the country's 514 districts. PARTICIPANTS Anonymised secondary data from 1 131 825 individual records in the National Socioeconomic Survey and 83 931 village records in the village census. Aggregate data for 220 million insured citizens. PRIMARY OUTCOME MEASURES Health service use and out-of-pocket payments, by health need, insurance status and service availability. Secondary outcome: insurance claims. RESULTS Self-reported national health insurance registration (60.6%) is about 10% lower compared with the insurer's report (71.1%). Insurance coverage is highest in poorer areas, where service provision, and thus service use and health spending, are lowest. Inpatient use is higher among the insured than the uninsured (OR 2.35, 95% CI 2.27 to 2.42), controlling for health need and access), and poorer patients are most likely to report free inpatient care (53% in wealth quintile 1 vs 41% in Q5). Insured patients spend US$ 3.14 more on hospitalisation than the uninsured (95% CI 1.98 to 4.31), but the difference disappears when controlled for wealth. Lack of services is a major constraint on service use, insurance claims and out-of-pocket spending. CONCLUSIONS The Indonesian public insurance system protects many inpatients, especially the poorest, from excessive spending. However, others, especially in Eastern Indonesia cannot benefit because few services are available. To achieve health equity, the Indonesian government needs to address supply side constraints and reduce structural underfunding.
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Affiliation(s)
- Agnes Bhakti Pratiwi
- Department of Ethics, Law, and Humanities, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hermawati Setiyaningsih
- Centre for Health Financing Policy and Health Insurance Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Maarten Olivier Kok
- Erasmus School for Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ali Ghufron Mukti
- Department of Public Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Elizabeth Pisani
- Erasmus School for Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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23
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Abonie US, Seves BL, Hoekstra F, Hoekstra T, van der Woude LH, Dekker R, Hettinga FJ. Assessment of Activity Pacing in Relation to Physical Activity and Health-Related Quality of Life in Adults with Multiple Sclerosis: A Foundation for Further Intervention Development. Int J MS Care 2021; 23:207-212. [PMID: 34720760 PMCID: PMC8550481 DOI: 10.7224/1537-2073.2020-047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND Activity pacing is a behavioral strategy for coping with fatigue, optimizing physical activity (PA) levels, and achieving a paced approach to lifestyle and sustainable self-regulated exercise practice to optimize health and well-being. Yet little is known about how activity pacing affects PA and health-related quality of life (HRQOL) while controlling for fatigue and demographic characteristics over time in adults with multiple sclerosis (MS). This study examined the natural use of activity pacing and how it is associated with PA and HRQOL over time in adults with MS. METHODS Sixty-eight adults with MS (mean ± SD age, 45.2 ± 10.9 years) completed questionnaires on their activity pacing, fatigue, PA, and HRQOL 14, 33, and 52 weeks after rehabilitation. Associations between the variables were examined using multilevel models. RESULTS No associations were found between activity pacing and PA (β = -0.01, P = .89) or between activity pacing and HRQOL (β = -0.15, P = .09). CONCLUSIONS This study provides an initial understanding of how activity pacing relates to PA and HRQOL in people with MS over time and indicates that there is no clear strategy among adults with MS that is successful in improving PA and HRQOL in the short or long term. Persons with MS may benefit from goal-directed activity pacing interventions to improve longitudinal engagement in PA, and the present study provides a foundation for further intervention development.
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Affiliation(s)
- Ulric S. Abonie
- From the Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Ghana (USA)
- School of Sport, Rehabilitation, and Exercise Science, University of Essex, Colchester, UK (USA)
| | - Bregje L. Seves
- Center for Human Movement Sciences (BLS, FH, TH, LHVvdW), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Femke Hoekstra
- Center for Human Movement Sciences (BLS, FH, TH, LHVvdW), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Rehabilitation (FH, LHVvdW, RD), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Trynke Hoekstra
- Center for Human Movement Sciences (BLS, FH, TH, LHVvdW), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Health Sciences and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands (TH)
| | - Lucas H.V. van der Woude
- Center for Human Movement Sciences (BLS, FH, TH, LHVvdW), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Rehabilitation (FH, LHVvdW, RD), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Rienk Dekker
- Department of Rehabilitation (FH, LHVvdW, RD), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Florentina J. Hettinga
- Department of Sport, Exercise, and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK (FJH)
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24
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Meijer RI, Hoekstra T, van den Oever NCG, Simsek S, van den Bergh JP, Douma RA, Reidinga AC, Moeniralam HS, Dormans T, Smits MM. Treatment with a DPP-4 inhibitor at time of hospital admission for COVID-19 is not associated with improved clinical outcomes: data from the COVID-PREDICT cohort study in The Netherlands. J Diabetes Metab Disord 2021; 20:1155-1160. [PMID: 34222054 PMCID: PMC8233181 DOI: 10.1007/s40200-021-00833-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/14/2021] [Indexed: 02/07/2023]
Abstract
Purpose Inhibition of dipeptidyl peptidase (DPP-)4 could reduce coronavirus disease 2019 (COVID-19) severity by reducing inflammation and enhancing tissue repair beyond glucose lowering. We aimed to assess this in a prospective cohort study. Methods We studied in 565 patients with type 2 diabetes in the CovidPredict Clinical Course Cohort whether use of a DPP-4 inhibitor prior to hospital admission due to COVID-19 was associated with improved clinical outcomes. Using crude analyses and propensity score matching (on age, sex and BMI), 28 patients using a DPP-4 inhibitor were identified and compared to non-users. Results No differences were found in the primary outcome mortality (matched-analysis = odds-ratio: 0,94 [95% confidence interval: 0,69 – 1,28], p-value: 0,689) or any of the secondary outcomes (ICU admission, invasive ventilation, thrombotic events or infectious complications). Additional analyses comparing users of DPP-4 inhibitors with subgroups of non-users (subgroup 1: users of metformin and sulphonylurea; subgroup 2: users of any insulin combination), allowing to correct for diabetes severity, did not yield different results. Conclusions We conclude that outpatient use of a DPP-4 inhibitor does not affect the clinical outcomes of patients with type 2 diabetes who are hospitalized because of COVID-19 infection.
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Affiliation(s)
- Rick I Meijer
- Department of Internal Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Suat Simsek
- Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands.,Department of Internal Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | | | - Renée A Douma
- Department of Internal Medicine, Flevohospital, Almere, The Netherlands
| | - Auke C Reidinga
- Department of Intensive Care Medicine, Martini Hospital, Groningen, The Netherlands
| | - Hazra S Moeniralam
- Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Tom Dormans
- Department of Intensive Care Medicine, Zuyderland Hospital, Heerlen, The Netherlands
| | | | - Mark M Smits
- Department of Internal Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.,Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Location Vumc, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands
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25
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de Boer DR, Hoekstra F, Huetink KIM, Hoekstra T, Krops LA, Hettinga FJ. Physical Activity, Sedentary Behavior and Well-Being of Adults with Physical Disabilities and/or Chronic Diseases during the First Wave of the COVID-19 Pandemic: A Rapid Review. Int J Environ Res Public Health 2021; 18:6342. [PMID: 34208156 PMCID: PMC8296179 DOI: 10.3390/ijerph18126342] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022]
Abstract
Background: People with physical disabilities and/or chronic diseases report lower levels of physical activity and well-being than the general population, which potentially is exacerbated through the COVID-19 pandemic. This study explored the international literature on physical activity, sedentary behavior and well-being in adults with physical disabilities and/or chronic diseases during the first wave of the pandemic. Method: In a rapid review, we included studies reporting on physical activity, sedentary behavior and/or well-being in adults with physical disabilities and/or chronic diseases. Four databases (Pubmed, CINAHL, PsycInfo, Embase) were searched for studies published until 30 September 2020. Results: We included twenty-nine studies involving eleven different types of disabilities or health conditions from twenty-one different countries. Twenty-six studies reported on physical activity, of which one reported an increase during the COVID-19 pandemic, four studies reported no difference, and twenty-one studies reported a decrease. Thirteen studies reported a decline in well-being. Only one study measured sedentary behavior, reporting an increase. Conclusion: Despite the variety in methods used, almost all studies reported negative impacts on physical activity and well-being in people with physical disabilities and/or chronic disease during the first wave of the pandemic. These findings highlight the importance of supporting this population, especially in times of crisis.
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Affiliation(s)
- Diederik R. de Boer
- Centre for Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands; (D.R.d.B.); (F.H.); (K.I.M.H.)
| | - Femke Hoekstra
- Centre for Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands; (D.R.d.B.); (F.H.); (K.I.M.H.)
- Faculty of Health and Social Development, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Kimberley I. M. Huetink
- Centre for Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands; (D.R.d.B.); (F.H.); (K.I.M.H.)
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Leonie A. Krops
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands;
| | - Florentina J. Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle NE1 8ST, UK
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Obura M, Beulens JWJ, Slieker R, Koopman ADM, Hoekstra T, Nijpels G, Elders P, Dekker JM, Koivula RW, Kurbasic A, Laakso M, Hansen TH, Ridderstråle M, Hansen T, Pavo I, Forgie I, Jablonka B, Ruetten H, Mari A, McCarthy MI, Walker M, McDonald TJ, Perry MH, Pearson ER, Franks PW, 't Hart LM, Rutters F. Clinical profiles of post-load glucose subgroups and their association with glycaemic traits over time: An IMI-DIRECT study. Diabet Med 2021; 38:e14428. [PMID: 33067862 DOI: 10.1111/dme.14428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/10/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022]
Abstract
AIM To examine the hypothesis that, based on their glucose curves during a seven-point oral glucose tolerance test, people at elevated type 2 diabetes risk can be divided into subgroups with different clinical profiles at baseline and different degrees of subsequent glycaemic deterioration. METHODS We included 2126 participants at elevated type 2 diabetes risk from the Diabetes Research on Patient Stratification (IMI-DIRECT) study. Latent class trajectory analysis was used to identify subgroups from a seven-point oral glucose tolerance test at baseline and follow-up. Linear models quantified the associations between the subgroups with glycaemic traits at baseline and 18 months. RESULTS At baseline, we identified four glucose curve subgroups, labelled in order of increasing peak levels as 1-4. Participants in Subgroups 2-4, were more likely to have higher insulin resistance (homeostatic model assessment) and a lower Matsuda index, than those in Subgroup 1. Overall, participants in Subgroups 3 and 4, had higher glycaemic trait values, with the exception of the Matsuda and insulinogenic indices. At 18 months, change in homeostatic model assessment of insulin resistance was higher in Subgroup 4 (β = 0.36, 95% CI 0.13-0.58), Subgroup 3 (β = 0.30; 95% CI 0.10-0.50) and Subgroup 2 (β = 0.18; 95% CI 0.04-0.32), compared to Subgroup 1. The same was observed for C-peptide and insulin. Five subgroups were identified at follow-up, and the majority of participants remained in the same subgroup or progressed to higher peak subgroups after 18 months. CONCLUSIONS Using data from a frequently sampled oral glucose tolerance test, glucose curve patterns associated with different clinical characteristics and different rates of subsequent glycaemic deterioration can be identified.
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Affiliation(s)
- M Obura
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - J W J Beulens
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - R Slieker
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Centre, Leiden, The Netherlands
| | - A D M Koopman
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - T Hoekstra
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands
| | - G Nijpels
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - P Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - J M Dekker
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - R W Koivula
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
| | - A Kurbasic
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
| | - M Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Finland
| | - T H Hansen
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - M Ridderstråle
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Hansen
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - I Pavo
- Eli Lilly Regional Operations GmbH, Vienna, Austria
| | - I Forgie
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK
| | - B Jablonka
- Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany
| | - H Ruetten
- Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany
| | - A Mari
- Institute of Biomedical Engineering, National Research Council, Padova, Italy
| | - M I McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - M Walker
- Institute of Cellular Medicine (Diabetes), Newcastle University, Newcastle upon Tyne, UK
| | - T J McDonald
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School and Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - M H Perry
- Department of Blood Sciences, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - E R Pearson
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - P W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - L M 't Hart
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Molecular Epidemiology Section, Leiden University Medical Centre, Leiden, The Netherlands
| | - F Rutters
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
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Seves BL, Hoekstra F, Schoenmakers JW, Brandenbarg P, Hoekstra T, Hettinga FJ, Dekker R, van der Woude LH, van der Schans CP. Test-retest reliability and concurrent validity of the Adapted Short QUestionnaire to ASsess Health-enhancing physical activity (Adapted-SQUASH) in adults with disabilities. J Sports Sci 2020; 39:875-886. [DOI: 10.1080/02640414.2020.1850983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Bregje L. Seves
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - Femke Hoekstra
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | - Jorrit W.A. Schoenmakers
- University of Groningen, University Medical Center Groningen, Department of Orthopedics, Groningen, The Netherlands
| | - Pim Brandenbarg
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Trynke Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Lucas H.V. van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise & Health Sciences, Loughborough University, UK
| | - Cees P. van der Schans
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
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28
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Obura M, Beulens JWJ, Slieker R, Koopman ADM, Hoekstra T, Nijpels G, Elders P, Koivula RW, Kurbasic A, Laakso M, Hansen TH, Ridderstråle M, Hansen T, Pavo I, Forgie I, Jablonka B, Ruetten H, Mari A, McCarthy MI, Walker M, Heggie A, McDonald TJ, Perry MH, De Masi F, Brunak S, Mahajan A, Giordano GN, Kokkola T, Dermitzakis E, Viñuela A, Pedersen O, Schwenk JM, Adamski J, Teare HJA, Pearson ER, Franks PW, ‘t Hart LM, Rutters F. Post-load glucose subgroups and associated metabolic traits in individuals with type 2 diabetes: An IMI-DIRECT study. PLoS One 2020; 15:e0242360. [PMID: 33253307 PMCID: PMC7703960 DOI: 10.1371/journal.pone.0242360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/31/2020] [Indexed: 11/19/2022] Open
Abstract
Aim Subclasses of different glycaemic disturbances could explain the variation in characteristics of individuals with type 2 diabetes (T2D). We aimed to examine the association between subgroups based on their glucose curves during a five-point mixed-meal tolerance test (MMT) and metabolic traits at baseline and glycaemic deterioration in individuals with T2D. Methods The study included 787 individuals with newly diagnosed T2D from the Diabetes Research on Patient Stratification (IMI-DIRECT) Study. Latent class trajectory analysis (LCTA) was used to identify distinct glucose curve subgroups during a five-point MMT. Using general linear models, these subgroups were associated with metabolic traits at baseline and after 18 months of follow up, adjusted for potential confounders. Results At baseline, we identified three glucose curve subgroups, labelled in order of increasing glucose peak levels as subgroup 1–3. Individuals in subgroup 2 and 3 were more likely to have higher levels of HbA1c, triglycerides and BMI at baseline, compared to those in subgroup 1. At 18 months (n = 651), the beta coefficients (95% CI) for change in HbA1c (mmol/mol) increased across subgroups with 0.37 (-0.18–1.92) for subgroup 2 and 1.88 (-0.08–3.85) for subgroup 3, relative to subgroup 1. The same trend was observed for change in levels of triglycerides and fasting glucose. Conclusions Different glycaemic profiles with different metabolic traits and different degrees of subsequent glycaemic deterioration can be identified using data from a frequently sampled mixed-meal tolerance test in individuals with T2D. Subgroups with the highest peaks had greater metabolic risk.
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Affiliation(s)
- Morgan Obura
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Joline W. J. Beulens
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- * E-mail:
| | - Roderick Slieker
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anitra D. M. Koopman
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Giel Nijpels
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Petra Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Robert W. Koivula
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, United Kingdom
| | - Azra Kurbasic
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Tue H. Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - Martin Ridderstråle
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Imre Pavo
- Eli Lilly Regional Operations GmbH, Vienna, Austria
| | - Ian Forgie
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, United Kingdom
| | - Bernd Jablonka
- Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany
| | - Hartmut Ruetten
- Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany
| | - Andrea Mari
- Institute of Biomedical Engineering, National Research Council, Padova, Italy
| | - Mark I. McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, United Kingdom
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Mark Walker
- Institute of Cellular Medicine (Diabetes), Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Alison Heggie
- Institute of Cellular Medicine (Diabetes), Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Timothy J. McDonald
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School and Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Mandy H. Perry
- Department of Blood Sciences, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Federico De Masi
- Department of Bio and Health Informatics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Søren Brunak
- Department of Bio and Health Informatics, Technical University of Denmark, Kongens Lyngby, Denmark
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anubha Mahajan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Giuseppe N. Giordano
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
| | - Tarja Kokkola
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Emmanouil Dermitzakis
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
- Institute of Genetics and Genomics in Geneva (iGE3), University of Geneva, Geneva, Switzerland
- Swiss Institute of Bioinformatics, Geneva, Switzerland
| | - Ana Viñuela
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
- Institute of Genetics and Genomics in Geneva (iGE3), University of Geneva, Geneva, Switzerland
- Swiss Institute of Bioinformatics, Geneva, Switzerland
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jochen M. Schwenk
- Affinity Proteomics, Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH—Royal Institute of Technology, Solna, Sweden
| | - Jurek Adamski
- Research Unit Molecular Endocrinology and Metabolism, Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Neuherberg, Germany
- Lehrstuhl für Experimentelle Genetik, Technische Universität München, Freising-Weihenstephan, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Harriet J. A. Teare
- HeLEX, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, United Kingdom
| | - Ewan R. Pearson
- Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Paul W. Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, United Kingdom
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States of America
| | - Leen M. ‘t Hart
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Molecular Epidemiology Section, Leiden University Medical Center, Leiden, The Netherlands
| | - Femke Rutters
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Location VU University Medical Center, Amsterdam, The Netherlands
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Twisk JW, Rijnhart JJ, Hoekstra T, Schuster NA, Ter Wee MM, Heymans MW. Intention-to-treat analysis when only a baseline value is available. Contemp Clin Trials Commun 2020; 20:100684. [PMID: 33319119 PMCID: PMC7726664 DOI: 10.1016/j.conctc.2020.100684] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/29/2020] [Accepted: 11/22/2020] [Indexed: 11/22/2022] Open
Abstract
Objectives How to perform an intention to treat (ITT) analysis when a patient has a baseline value but no follow-up measurements is problematic. The purpose of this study was to compare different methods that deal with this problem, i.e. no imputation (standard and alternative mixed model analysis), single imputation (i.e. baseline value carried forward), and multiple imputation (selective and non-selective). Study design and setting We used a simulation study with different scenarios regarding 1) the association between missingness and the baseline value, 2) whether the patients did or did not receive the treatment, and 3) the percentage of missing data, and two real life data sets. Results Bias and coverage were comparable between the two mixed model analyses and multiple imputation in most situations including the real life data examples. Only in the situation when the patients in the treatment group were simulated not to have received the treatment, selective imputation using this information outperformed all other methods. Conclusions In most situations a standard mixed model analysis without imputation is appropriate as ITT analysis. However, when patients with missing follow-up data allocated to the treatment group did not received treatment, it is advised to use selective imputation, using this information, although the results should be interpreted with caution.
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Affiliation(s)
- Jos Wr Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, UMC Amsterdam, the Netherlands
| | - Judith Jm Rijnhart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, UMC Amsterdam, the Netherlands
| | - Trynke Hoekstra
- Department of Health Science, Amsterdam Public Health Research Institute, Faculty of Science, VU University, Amsterdam, the Netherlands
| | - Noah A Schuster
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, UMC Amsterdam, the Netherlands
| | - Marieke M Ter Wee
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, UMC Amsterdam, the Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, UMC Amsterdam, the Netherlands
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Seves BL, Hoekstra T, Hoekstra F, Hettinga FJ, Dekker R, van der Woude LHV. Unravelling perceived fatigue and activity pacing in maintaining a physically active lifestyle after stroke rehabilitation: a longitudinal cohort study. Disabil Rehabil 2020; 43:3492-3502. [DOI: 10.1080/09638288.2020.1833090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Bregje L. Seves
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Rienk Dekker
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lucas H. V. van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Wesseling M, Kainz H, Hoekstra T, Van Rossom S, Desloovere K, De Groote F, Jonkers I. Botulinum toxin injections minimally affect modelled muscle forces during gait in children with cerebral palsy. Gait Posture 2020; 82:54-60. [PMID: 32892101 DOI: 10.1016/j.gaitpost.2020.08.122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/10/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Children with cerebral palsy (CP) present altered gait patterns and electromyography (EMG) activity compared to typically developing children. To temporarily reduce muscular activity and to correct the abnormal muscle force balance, Botulinum Toxin type A (BTX-A) injections are used. RESEARCH QUESTION What is the effect of BTX-A injections on dynamic muscle forces during gait, when calculated using an EMG-constrained approach?. METHODS Retrospective data of ten typically developing (TD) and fourteen children with spastic diplegic CP were used for musculoskeletal modeling and dynamic simulations of gait, before and after BTX-A treatment. Individual muscle forces were calculated using an EMG-constrained optimization, in which EMG of eight muscles was used as muscle excitation signal to constrain the muscle activation patterns. Paired t-tests were used to compare average modelled muscle forces in different phases of the gait cycle pre- and post-BTX-A, summarized in the muscle profile score. Two-sample t-tests were used to determine significant differences between TD and pre- and post-BTX-A modelled muscle forces. RESULTS For most muscles, the force was decreased in CP compared to TD children in all phases of the gait cycle, both before and after BTX-A treatment. Differences in muscle forces before and after BTX-A treatment were limited, with only few significant differences between pre- and post-BTX-A. Compared to a standard static optimization approach, imposing the EMG activity increased modelled muscle forces for most muscles. SIGNIFICANCE Our findings indicate that BTX-A treatment has a limited effect on the muscle balance in CP children. Besides that, the use of EMG-constrained optimization is recommended when studying muscle balance in children with CP.
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Affiliation(s)
- M Wesseling
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.
| | - H Kainz
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium; Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria.
| | - T Hoekstra
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.
| | - S Van Rossom
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.
| | - K Desloovere
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU, Leuven, Belgium.
| | - F De Groote
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.
| | - I Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.
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Hoekstra T, Rojer AGM, van Schoor NM, Maier AB, Pijnappels M. Distinct Trajectories of Individual Physical Performance Measures Across 9 Years in 60- to 70-Year-Old Adults. J Gerontol A Biol Sci Med Sci 2020; 75:1951-1959. [PMID: 32052013 PMCID: PMC7518554 DOI: 10.1093/gerona/glaa045] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Indexed: 01/29/2023] Open
Abstract
Background Physical performance is an important factor for successful aging. This study aimed to identify distinct trajectories of multiple physical performance measures over 9 years in individuals aged 60–70 years and to evaluate their characteristics and the overlap between measures. Methods Four physical performance measures were assessed in 440 participants of the Longitudinal Aging Study Amsterdam: tandem stand, gait speed, chair stand, and handgrip strength. Gender-specific latent class models were conducted to obtain distinct trajectories and their degree of overlap. Results Mean age at baseline was 67.9 (SD 1.7) years for males and 68.0 (SD 1.7) years for females. The optimal number of trajectories differed across measures. For tandem stand, no distinct trajectories were found (all 179 males, 198 females). For gait speed, three trajectories were identified, dependent on baseline speed: high-stable (47 males, 27 females), intermediate-stable (132 males, 130 females), and low-declining performance (6 males, 48 females). Two trajectories were identified for the chair stand: a stable (168 males, 150 females) and declining trajectory (10 males, 38 females). For handgrip strength, three declining trajectories were identified differing in baseline performance: high (55 males, 75 females), intermediate (111 males, 118 females), and low (17 males, 10 females). Overall, 11.9% of males and 5.7% of females were classified in similar trajectories across measures. Conclusions Trajectories of physical performance were heterogeneous, but showed similar patterns for males and females. Little overlap between measures was shown, suggesting different mechanisms for decline. This study emphasizes the use of multiple domains to assess physical performance.
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Affiliation(s)
- Trynke Hoekstra
- Department of Health Sciences and the Amsterdam Public Health Research Institute, Faculty of Science, Vrije Universiteit Amsterdam, the Netherlands
| | - Anna Galina Maria Rojer
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, the Netherlands
| | - Natasja M van Schoor
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, the Netherlands
| | - Andrea Britta Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, the Netherlands.,Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, the Netherlands
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Kwint M, Stam B, Proust-Lima C, Philipps V, Hoekstra T, Aalbersberg E, Rossi M, Sonke JJ, Belderbos J, Walraven I. The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patients. Radiother Oncol 2020; 146:44-51. [DOI: 10.1016/j.radonc.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/05/2019] [Accepted: 02/05/2020] [Indexed: 02/09/2023]
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Borst RAJ, Hoekstra T, Muhangi D, Jonker I, Kok MO. Reaching rural communities through 'Healthy Entrepreneurs': a cross-sectional exploration of community health entrepreneurship's role in sexual and reproductive health. Health Policy Plan 2020; 34:676-683. [PMID: 31774511 PMCID: PMC6880333 DOI: 10.1093/heapol/czz091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 11/19/2022] Open
Abstract
The purpose of the current study was to explore the association between community health entrepreneurship and the sexual and reproductive health status of rural households in West-Uganda. We collected data using digital surveys in a cluster-randomized cross-sectional cohort study. The sample entailed 1211 household members from 25 randomly selected villages within two subcounties, of a rural West-Ugandan district. The association between five validated sexual and reproductive health outcome indicators and exposure to community health entrepreneurship was assessed using wealth-adjusted mixed-effects logistic regression models. We observed that households living in an area where community health entrepreneurs were active reported more often to use at least one modern contraceptive method [odds ratios (OR): 2.01, 95% CI: 1.30–3.10] had more knowledge of modern contraceptive methods (OR: 7.75, 95% CI: 2.81–21.34), knew more sexually transmitted infections (OR: 1.86, 95% CI: 1.14–3.05), and mentioned more symptoms of sexually transmitted infections (OR: 1.83, 95% CI: 1.18–2.85). The association between exposure to community health entrepreneurship and communities’ comprehensive knowledge of HIV/AIDS was more ambiguous (OR: 1.27, 95% CI: 0.97–1.67). To conclude, households living in areas where community health entrepreneurs were active had higher odds on using modern contraceptives and had more knowledge of modern contraceptive methods, sexually transmitted infections and symptoms of sexually transmitted infections. This study provides the first evidence supporting the role of community health entrepreneurship in providing rural communities with sexual and reproductive health care.
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Affiliation(s)
- Robert A J Borst
- Erasmus School of Health Policy & Management, Health Care Governance, Erasmus University Rotterdam, DR Rotterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1085, HV, Amsterdam, The Netherlands
| | - Denis Muhangi
- Department of Social Work and Social Administration, Makerere University, Kampala, Uganda
| | - Isis Jonker
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1085, HV, Amsterdam, The Netherlands
| | - Maarten Olivier Kok
- Erasmus School of Health Policy & Management, Health Care Governance, Erasmus University Rotterdam, DR Rotterdam, The Netherlands.,Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1085, HV, Amsterdam, The Netherlands
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Jenks AD, Hoekstra T, Axén I, de Luca K, Field J, Newell D, Hartvigsen J, French SD, Koes B, van Tulder MW, Rubinstein SM. BAck complaints in the elders - chiropractic (BACE-C): protocol of an international cohort study of older adults with low back pain seeking chiropractic care. Chiropr Man Therap 2020; 28:17. [PMID: 32238185 PMCID: PMC7110664 DOI: 10.1186/s12998-020-00302-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/13/2020] [Indexed: 11/15/2022] Open
Abstract
Background Low back pain is a common condition among older adults that significantly influences physical function and participation. Compared to their younger counterparts, there is limited information available about the clinical course of low back pain in older people, in particularly those presenting for chiropractic care. Improving our understanding of this patient population and the course of their low back pain may provide input for studies researching safer and more effective care than is currently provided. Objectives The primary objectives are to examine the clinical course over one year of pain intensity, healthcare costs and pain, functional status and recovery rates of low back pain in people 55 years and older who visit a chiropractor for a new episode of low back pain. Methods An international prospective, multi-center cohort study with one-year follow-up. Chiropractic practices are to be recruited in the Netherlands, Sweden, United Kingdom and Australia. Treatment will be left to the discretion of the chiropractor. Inclusion/Exclusion criteria: Patients aged 55 and older who consult a chiropractor for a new episode of low back pain, meaning low back pain for the first time or those patients who have not been to a chiropractor in the previous six months. This is independent of whether they have seen another type of health care provider for the current episode. Patients who are unable to complete the web-based questionnaires because of language restrictions or those with computer literacy restrictions will be excluded as well as those with cognitive disorders. In addition, those with a suspected tumor, fracture, infection or any other potential red flag or condition considered to be a contraindication for chiropractic care will be excluded. Data will be collected using online questionnaires at baseline, and at 2 and 6 weeks and at 3, 6, 9 and 12 months. Discussion This study, to our knowledge, is the first large-scale, prospective, multicenter, international cohort study to be conducted in a chiropractic setting to focus on older adults with low back pain consulting a chiropractor. By understanding the clinical course, satisfaction and safety of chiropractic treatment of this common debilitating condition in the aged population, this study will provide input for informing future clinical trials. Trial registration Nederlandse Trial Registrar NL7507.
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Affiliation(s)
- Alan D Jenks
- Department of Health Sciences and Amsterdam Movement Science, Faculty of Science, Vrije Universiteit, De Boelelaan 1085, room WN U601, 1081HV, Amsterdam, The Netherlands.
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Science, Vrije Universiteit, Amsterdam, Netherlands
| | - Iben Axén
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Katie de Luca
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | | | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Simon D French
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Bart Koes
- Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands.,Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - Maurits W van Tulder
- Department of Health Sciences and Amsterdam Movement Science, Faculty of Science, Vrije Universiteit, De Boelelaan 1085, room WN U601, 1081HV, Amsterdam, The Netherlands.,Department of Physiotherapy & Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Sidney M Rubinstein
- Department of Health Sciences and Amsterdam Movement Science, Faculty of Science, Vrije Universiteit, De Boelelaan 1085, room WN U601, 1081HV, Amsterdam, The Netherlands
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Verhoog S, Dopmeijer JM, de Jonge JM, van der Heijde CM, Vonk P, Bovens RH, de Boer MR, Hoekstra T, Kunst AE, Wiers RW, Kuipers MA. The Use of the Alcohol Use Disorders Identification Test − Consumption as an Indicator of Hazardous Alcohol Use among University Students. Eur Addict Res 2020; 26:1-9. [PMID: 31563902 PMCID: PMC6979415 DOI: 10.1159/000503342] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 09/12/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hazardous drinking among students in higher education is a growing concern. The alcohol use disorders identification test (AUDIT) is the gold standard screening instrument for hazardous drinking in the adult population, for which an abbreviated version has been developed: the -AUDIT-Consumption (AUDIT-C). Currently, there's no gold standard for identifying hazardous drinking among students in higher education and little evidence regarding the concurrent validity of the AUDIT-C as a screening instrument for this group. This study investigated the concurrent validity of the AUDIT-C in a sample of university students and suggests the most appropriate cutoff points. METHODS Cross-sectional data of health surveys from 5,401 university and university of applied sciences in the Netherlands were used. Receiver operating characteristic (ROC) curves, sensitivity, specificity, and positive and negative predictive values for different cutoff scores of AUDIT-C were calculated for the total sample and for subgroups stratified by age, gender, and educational level. AUDIT-score ≥11 was used as the criterion of hazardous and harmful drinking. RESULTS Twenty percent of students were hazardous and harmful drinkers. The area under the ROC curve was 0.922 (95% CI 0.914-0.930). At an AUDIT-C cutoff score of ≥7, sensitivity and specificity were both >80%, while other cutoffs showed less balanced results. A cutoff of ≥8 performed better among males, but for other subgroups ≥7 was most suitable. CONCLUSION AUDIT-C seems valid in identifying hazardous and harmful drinking students, with suggested optimal cutoffs 7 (females) or 8 (males). However, considerations regarding avoiding false-positives versus false-negatives, in relation to the type of intervention following screening, could lead to selecting different cutoffs.
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Affiliation(s)
- Sanne Verhoog
- aAcademic Medical Center, Department of Public Health, University of Amsterdam, Amsterdam, The Netherlands,bInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Jolien M. Dopmeijer
- cDepartment of Health and Welfare, Windesheim University of Applied Sciences, Research Group Mental Healthcare and Society, Zwolle, The Netherlands,gDepartment of Psychology, Addiction Development and Psychopathology Lab, University of Amsterdam, Amsterdam, The Netherlands,*Jolien Mariët Dopmeijer, Department of Health and Welfare, Mental Healthcare and Society, Windesheim University of Applied Sciences, Campus 2-6, NL–8017 CA Zwolle (The Netherlands), E-Mail
| | - Jannet M. de Jonge
- cDepartment of Health and Welfare, Windesheim University of Applied Sciences, Research Group Mental Healthcare and Society, Zwolle, The Netherlands
| | - Claudia M. van der Heijde
- dDepartment of Research, Student Health Service, Development and Prevention, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Vonk
- dDepartment of Research, Student Health Service, Development and Prevention, University of Amsterdam, Amsterdam, The Netherlands
| | - Rob H.L.M. Bovens
- eTranzo, Scientific Center for Care and Welfare, University of Tilburg, Tilburg, The Netherlands
| | - Michiel R. de Boer
- fDepartment of Health Sciences, VU University, Section Methodology and Applied Statistics, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- fDepartment of Health Sciences, VU University, Section Methodology and Applied Statistics, Amsterdam, The Netherlands
| | - Anton E. Kunst
- aAcademic Medical Center, Department of Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Reinout W. Wiers
- gDepartment of Psychology, Addiction Development and Psychopathology Lab, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirte A.G. Kuipers
- aAcademic Medical Center, Department of Public Health, University of Amsterdam, Amsterdam, The Netherlands
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Hoekstra F, Hoekstra T, van der Schans CP, Hettinga FJ, van der Woude LHV, Dekker R. The implementation of a physical activity counseling program in rehabilitation care: findings from the ReSpAct study. Disabil Rehabil 2019; 43:1710-1721. [PMID: 31622120 DOI: 10.1080/09638288.2019.1675188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE This study aimed to evaluate the implementation of a physical activity counseling program in rehabilitation and to study heterogeneity in received counseling and investigate its association with changes in patients' physical activity outcomes. METHODS This prospective cohort study was conducted in 18 rehabilitation institutions. Data were collected using surveys completed by professionals (n= ±70) and patients (n = 1719). Implementation was evaluated using different process outcomes: reach, dosage, satisfaction, maintenance. Patients' physical activity outcomes included changes in total minutes/week of physical activity. Latent class analyses were conducted to identify profiles of received counseling characteristics and multilevel models were used to investigate associations with physical activity outcomes. RESULTS 5873 Patients were provided with motivational interviewing-based counseling after rehabilitation. Professionals and patients were positive about the program. Sixteen institutions (89%) formally agreed to continue the program. The four identified profiles of counseling characteristics illustrate a large variation in received counseling among patients. No substantial differences in physical activity outcomes were found between profiles. CONCLUSION After a three-year program period, the physical activity counseling centers were sustainably implemented in Dutch rehabilitation care. This study illustrated an innovative approach to assess heterogeneity in implementation outcomes (e.g., counseling profiles) in relation to program outcomes (e.g., physical activity).Implications for rehabilitationPhysical activity counseling after rehabilitation is important to support people with disabilities in making the step from rehabilitation-based physical activities to community-based physical activities.Establishing "Physical Activity Counseling Centers" is a promising "disability-overarching" strategy to promote physical activity after rehabilitation.Although the actual received counseling (dosage) varied among patients, this did not coincide with large differences in physical activity outcomes.The training in Motivational Interviewing, the financial incentives, and the advisory support were considered as important or essential ingredients for a successful implementation of the counseling program in rehabilitation practice.
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Affiliation(s)
- Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Trynke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Dept Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Florentina J Hettinga
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, United Kingdom
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rienk Dekker
- Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Paul MC, Dik JWH, Hoekstra T, van Dijk CE. Admissions for ambulatory care sensitive conditions: a national observational study in the general and COPD population. Eur J Public Health 2019; 29:213-219. [PMID: 30212895 PMCID: PMC6426039 DOI: 10.1093/eurpub/cky182] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hospital admissions for ambulatory care sensitive conditions (ACSCs) may be prevented by effective ambulatory management and treatment. ACSC admissions is used as indicator for primary care quality and accessibility. However, debate continues to which extent these admissions are truly preventable. The aim of this study was to provide more objective insight into the preventability of ACSC admissions. METHODS Observational study using 2012-15 health insurer claim data of 13 182 602 Dutch insured inhabitants. Logistic multilevel regression analyses were conducted to investigate factors (ambulatory care and characteristics of inhabitants) possibly associated with ACSC admissions. Prior ambulatory care use was examined for patients with an ACSC contributing to the highest number of ACSC admissions: chronic obstructive pulmonary disease (COPD). RESULTS In 2014, 89.8 hospital admissions for ACSCs per 10 000 insured inhabitants were claimed. Percentage of inhabitants with ACSC admissions varied between general practices from 0.58-0.84%. ASCS admissions were hardly associated with ambulatory care. One month prior to admission, 97% of admitted COPD patients had at least one ambulatory care contact. CONCLUSIONS Variation in ACSC admissions between general practitioners was observed, indicating that certain hospital admissions may be prevented. However, we found no indication that ACSC admissions were preventable, as no link was found with the provision of ambulatory care and ACSC admissions. This may indicate that this indicator is country and health care system specific. Before including ACSC admission as quality indicator of primary care in the Netherlands, more insight into the causes of variation is required.
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Affiliation(s)
- Marieke C Paul
- National Healthcare Institute, Diemen, The Netherlands.,Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Trynke Hoekstra
- Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Jonkman NH, Colpo M, Klenk J, Todd C, Hoekstra T, Del Panta V, Rapp K, van Schoor NM, Bandinelli S, Heymans MW, Mauger D, Cattelani L, Denkinger MD, Rothenbacher D, Helbostad JL, Vereijken B, Maier AB, Pijnappels M. Development of a clinical prediction model for the onset of functional decline in people aged 65-75 years: pooled analysis of four European cohort studies. BMC Geriatr 2019; 19:179. [PMID: 31248370 PMCID: PMC6595632 DOI: 10.1186/s12877-019-1192-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 06/18/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Identifying those people at increased risk of early functional decline in activities of daily living (ADL) is essential for initiating preventive interventions. The aim of this study is to develop and validate a clinical prediction model for onset of functional decline in ADL in three years of follow-up in older people of 65-75 years old. METHODS Four population-based cohort studies were pooled for the analysis: ActiFE-ULM (Germany), ELSA (United Kingdom), InCHIANTI (Italy), LASA (Netherlands). Included participants were 65-75 years old at baseline and reported no limitations in functional ability in ADL at baseline. Functional decline was assessed with two items on basic ADL and three items on instrumental ADL. Participants who reported at least some limitations at three-year follow-up on any of the five items were classified as experiencing functional decline. Multiple logistic regression analysis was used to develop a prediction model, with subsequent bootstrapping for optimism-correction. We applied internal-external cross-validation by alternating the data from the four cohort studies to assess the discrimination and calibration across the cohorts. RESULTS Two thousand five hundred sixty community-dwelling people were included in the analyses (mean age 69.7 ± 3.0 years old, 47.4% female) of whom 572 (22.3%) reported functional decline at three-year follow-up. The final prediction model included 10 out of 22 predictors: age, handgrip strength, gait speed, five-repeated chair stands time (non-linear association), body mass index, cardiovascular disease, diabetes, chronic obstructive pulmonary disease, arthritis, and depressive symptoms. The optimism-corrected model showed good discrimination with a C statistic of 0.72. The calibration intercept was 0.06 and the calibration slope was 1.05. Internal-external cross-validation showed consistent performance of the model across the four cohorts. CONCLUSIONS Based on pooled cohort data analyses we were able to show that the onset of functional decline in ADL in three years in older people aged 65-75 years can be predicted by specific physical performance measures, age, body mass index, presence of depressive symptoms, and chronic conditions. The prediction model showed good discrimination and calibration, which remained stable across the four cohorts, supporting external validity of our findings.
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Affiliation(s)
- Nini H. Jonkman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Marco Colpo
- Laboratory of Clinical Epidemiology, InCHIANTI Study Group, LHTC Local Health Tuscany Center, Firenze, Italy
| | - Jochen Klenk
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre and Manchester University NHS Foundation Trust, Manchester, UK
| | - Trynke Hoekstra
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Vieri Del Panta
- Laboratory of Clinical Epidemiology, InCHIANTI Study Group, LHTC Local Health Tuscany Center, Firenze, Italy
| | - Kilian Rapp
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Natasja M. van Schoor
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Stefania Bandinelli
- Laboratory of Clinical Epidemiology, InCHIANTI Study Group, LHTC Local Health Tuscany Center, Firenze, Italy
| | - Martijn W. Heymans
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Dominique Mauger
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Luca Cattelani
- Department of Computer Science and Engineering, University of Bologna, Bologna, Italy
| | - Michael D. Denkinger
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Geriatric Research Unit Ulm University and Geriatric Center, Agaplesion Bethesda Hospital Ulm, Ulm, Germany
| | | | - Jorunn L. Helbostad
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andrea B. Maier
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Faculty of Medicine Dentistry and Health Sciences, Medicine and Aged Care, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Hoekstra T, Alingh RA, de Vries HS, Bes R, Hoekstra F, van der Schans CP, Dekker R, Hettinga FJ, van der Woude LHV. A questionnaire to assess rehabilitation patients’ experiences with motivational interviewing consultation in the context of physical activity stimulation. Disabil Rehabil 2019; 42:2198-2203. [DOI: 10.1080/09638288.2018.1545055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Trynke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Rolinde A. Alingh
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Rik Bes
- Centre for Motivation and Change, Hilversum, The Netherlands
| | - Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P. van der Schans
- Research and Innovation Group in Health Care and Nursing, Hanze University Groningen, Groningen, The Netherlands
| | - Rienk Dekker
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Center for Sports Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Florentina J. Hettinga
- School of Biological Sciences, Centre of Sport and Exercise Science, University of Essex, Colchester, UK
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Tonneijck L, Smits MM, Muskiet MHA, Hoekstra T, Kramer MHH, Danser AHJ, Ter Wee PM, Diamant M, Joles JA, van Raalte DH. Erratum. Renal Effects of DPP-4 Inhibitor Sitagliptin or GLP-1 Receptor Agonist Liraglutide in Overweight Patients With Type 2 Diabetes: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial. Diabetes Care 2016;39:2042-2050. Diabetes Care 2019; 42:494. [PMID: 30674545 PMCID: PMC6385692 DOI: 10.2337/dc19-er03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Evenblij K, Pasman HRW, van der Heide A, Hoekstra T, Onwuteaka-Philipsen BD. Factors associated with requesting and receiving euthanasia: a nationwide mortality follow-back study with a focus on patients with psychiatric disorders, dementia, or an accumulation of health problems related to old age. BMC Med 2019; 17:39. [PMID: 30777057 PMCID: PMC6379969 DOI: 10.1186/s12916-019-1276-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/31/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Recently, euthanasia and assisted suicide (EAS) in patients with psychiatric disorders, dementia, or an accumulation of health problems has taken a prominent place in the public debate. However, limited is known about this practice. The purpose of this study was threefold: to estimate the frequency of requesting and receiving EAS among people with (also) a psychiatric disorder, dementia, or an accumulation of health problems; to explore reasons for physicians to grant or refuse a request; and to describe differences in characteristics, including the presence of psychiatric disorders, dementia, and accumulation of health problems, between patients who did and did not request EAS and between patients whose request was or was not granted. METHODS A nationwide cross-sectional survey study was performed. A stratified sample of death certificates of patients who died between 1 August and 1 December 2015 was drawn from the central death registry of Statistics Netherlands. Questionnaires were sent to the certifying physician (n = 9351, response 78%). Only deceased patients aged ≥ 17 years and who died a non-sudden death were included in the analyses (n = 5361). RESULTS The frequency of euthanasia requests among deceased people who died non-suddenly and with (also) a psychiatric disorder (11.4%), dementia (2.1%), or an accumulation of health problems (8.0%) varied. Factors positively associated with requesting euthanasia were age (< 80 years), ethnicity (Dutch/Western), cause of death (cancer), attending physician (general practitioner), and involvement of a pain specialist or psychiatrist. Cause of death (neurological disorders, another cause) and attending physician (general practitioner) were also positively associated with receiving euthanasia. Psychiatric disorders, dementia, and/or an accumulation of health problems were negatively associated with both requesting and receiving euthanasia. CONCLUSIONS EAS in deceased patients with psychiatric disorders, dementia, and/or an accumulation of health problems is relatively rare. Partly, this can be explained by the belief that the due care criteria cannot be met. Another explanation is that patients with these conditions are less likely to request EAS.
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Affiliation(s)
- Kirsten Evenblij
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - H Roeline W Pasman
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Agnes van der Heide
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
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Tieks A, Troelstra SA, Hoekstra T, Kunst AE. Associations of the Stoptober smoking cessation program with information seeking for smoking cessation: A Google trends study. Drug Alcohol Depend 2019; 194:97-100. [PMID: 30419407 DOI: 10.1016/j.drugalcdep.2018.08.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 08/17/2018] [Accepted: 08/22/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The national smoking cessation program Stoptober was introduced in October 2012 in England and in October 2014 in the Netherlands. There is little evidence on the extent to which the Stoptober program has an impact on smoking-related outcomes at national levels. We aimed to measure the magnitude and timing of the associations of the Dutch Stoptober program with searching for smoking cessation on the internet. METHODS An interrupted time series analysis was used on Google search queries. Data were seasonally adjusted and analyzed using autoregressive integrated moving average (ARIMA) modelling. To examine the magnitude and timing of the program, nine potential intervention periods around early October were analyzed simultaneously, with control for national tobacco control policies. Parallel analyses were made of Belgium as a control group. RESULTS The 2014-2016 Dutch Stoptober programs were associated with a significant increase in relative search volume (RSV) in the week the challenge starts (11%, 95% CI: 1-21), the next week (22%, 95% CI: 12-33) and the week afterward (17%, 95% CI: 8-27). A smaller, non-significant increase was observed in the two weeks before the challenge. No substantial increases were found in the Belgian control group. CONCLUSIONS In the Netherlands, the Stoptober program was associated with a substantial short-term increase in information seeking for smoking cessation. This suggests that Stoptober may be able to affect smoking-related outcomes in national populations at large.
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Affiliation(s)
- Alieke Tieks
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Sigrid A Troelstra
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - Anton E Kunst
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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McPherson SM, Burduli E, Smith CL, Brooks O, Orr MF, Barbosa-Leiker C, Hoekstra T, McDonell MG, Murphy SM, Layton M, Roll JM. Predictors of tobacco and alcohol co-use from ages 15 to 32: The Amsterdam Growth and Health Longitudinal Study. Exp Clin Psychopharmacol 2018; 26:549-559. [PMID: 30148405 PMCID: PMC6946685 DOI: 10.1037/pha0000203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Tobacco and alcohol are often used in tandem over time, but specific predictors of course and patterns of course over time need explication. We examined differences in alcohol and tobacco course among an adolescent population as they transitioned into young adulthood across a 17-year period. Data came from participants (n = 303 for ages 15-21, n = 196 for ages 21 to 32; 52% female and 54% female, respectively) enrolled in the Amsterdam Growth and Health Longitudinal Study, an epidemiologic investigation examining disease across the life span. We utilized parallel latent growth modeling to assess the impact of sex, personality traits, cholesterol, blood pressure, and body mass index (BMI), on initial status and linear change over time in course of tobacco and alcohol. Females reported less alcohol use at adolescent baseline (β = -21.79), less increase during adolescence (β = -7.92, p < .05), slower decrease during young adulthood (β = 4.67, p < .05), and more rapid decline in tobacco use during young adulthood (β = -70.85, p < .05), relative to males. Alcohol and tobacco use baseline status' and change over time were all significantly associated with one another during both adolescence and young adulthood (p < .05; aside from alcohol baseline and slope during young adulthood). Effects of BMI, cholesterol, blood pressure, and personality traits were also observed on tobacco and alcohol course. In light of the strong, but sex dependent relationship between alcohol and tobacco course, particularly from ages 15 to 21, prevention efforts to curb heavy alcohol and tobacco use should consider targeting course taking into account biological sex and other notable covariates. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Sijbrandij JJ, Hoekstra T, Almansa J, Reijneveld SA, Bültmann U. Identifying subclasses based on developmental trajectories: comparing three latent class techniques. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- JJ Sijbrandij
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, Netherlands
| | - T Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, Netherlands
| | - J Almansa
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, Netherlands
| | - SA Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, Netherlands
| | - U Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, Netherlands
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Hoekstra T, Cornelius LR, Sjobbema C, Wilming L, Brouwer S. Impact of coping, illness cognitions and perceived health on treatment adherence in disabled workers. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Community and Occupational Medicine, Research Center for Insurance Medicine Amsterdam, Groningen, Netherlands
| | - L R Cornelius
- University of Groningen, University Medical Center Groningen, Department of Community and Occupational Medicine, Research Center for Insurance Medicine Amsterdam, Groningen, Netherlands
| | - C Sjobbema
- Research Center for Insurance Medicine Amsterdam, Groningen, Netherlands
| | - L Wilming
- University of Groningen, University Medical Center Groningen, Department of Community and Occupational Medicine, Research Center for Insurance Medicine Amsterdam, Groningen, Netherlands
| | - S Brouwer
- University of Groningen, University Medical Center Groningen, Department of Community and Occupational Medicine, Research Center for Insurance Medicine Amsterdam, Groningen, Netherlands
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Bouwhuis S, Hoekstra T, Bongers PM, Boot CRL, Geuskens GA, van der Beek AJ. Distinguishing groups and exploring health differences among multiple job holders aged 45 years and older. Int Arch Occup Environ Health 2018; 92:67-79. [PMID: 30196318 PMCID: PMC6323084 DOI: 10.1007/s00420-018-1351-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/29/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To identify distinct groups of older multiple job holders and to explore health differences between these groups. METHODS We selected respondents from STREAM, a Dutch cohort study among persons aged 45 years and older, who reported having multiple jobs (N = 702). We applied latent class analysis to identify groups of multiple job holders. The association between these groups and health, measured with the SF-12, was studied cross-sectionally and longitudinally (1 year of follow-up), using linear regression analyses. RESULTS Four groups of older multiple job holders were identified: (1) a vulnerable group (N = 145), who preferred having one job, and had jobs with high demands and low resources; (2) an indifferent group (N = 134), who did not experience many benefits or disadvantages of multiple job holding (MJH); (3) a satisfied hybrid group, who were all self-employed in their second job (N = 310); and (4) a satisfied combination group, who all had a second job as an employee (N = 113). Both the satisfied hybrid and satisfied combination groups preferred MJH and experienced benefits of it. At baseline, the vulnerable group experienced significantly lower physical and mental health than the other groups. We found no significant differences regarding changes in health after 1 year. CONCLUSIONS Four groups of older multiple job holders could be distinguished. The vulnerable group experienced lower physical and mental health at baseline than the other three groups. Policies and interventions supporting vulnerable multiple job holders may need to be developed. Future research is recommended to take heterogeneity among multiple job holders into account.
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Affiliation(s)
- Stef Bouwhuis
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands. .,Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands. .,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands.
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Paulien M Bongers
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands.,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Goedele A Geuskens
- Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands.,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
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Sirkka O, Vrijkotte T, Halberstadt J, Abrahamse‐Berkeveld M, Hoekstra T, Seidell J, Olthof M. Prospective associations of age at complementary feeding and exclusive breastfeeding duration with body mass index at 5-6 years within different risk groups. Pediatr Obes 2018; 13:522-529. [PMID: 29695025 PMCID: PMC6099412 DOI: 10.1111/ijpo.12289] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 03/16/2018] [Accepted: 03/21/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Children with overweight or obesity are at risk for developing obesity in adulthood. Certain maternal characteristics, such as ethnicity, education, body mass index (BMI) or neighbourhood, are determinants for childhood overweight risk. There are large variations in how mothers differing in these characteristics feed their infants. Therefore, associations of age at complementary feeding, exclusive breast feeding duration with childhood overweight may differ in these groups. Understanding these associations would be essential to develop overweight prevention strategies. OBJECTIVES The objective of this study is to study the associations of age at complementary feeding, exclusive breastfeeding duration with BMI-standard deviation score (SDS) at 5-6 years within risk groups. METHODS Using data from the Amsterdam Born Children and their Development study, a population-based birth cohort (n = 4495), we formed groups of children at varying risk of overweight according to maternal characteristics of ethnicity, education, pre-pregnancy BMI and neighbourhood. Linear and logistic regression analyses were conducted. RESULTS Complementary feeding after 5 months of age was associated with lower BMI-SDS in children of mothers of Dutch ethnicity (B: -0.12; 95% CI: -0.21, -0.04), medium-level education (-0.19; -0.30, -0.08), normal BMI (-0.08; -0.16, -0.01) and high-risk neighbourhood (-0.16; -0.29, -0.02). Compared with exclusive breastfeeding for <3 months, exclusive breastfeeding for ≥6 months was associated with lower BMI-SDS in groups of medium-level education (-0.28; 0.44, -0.11), normal BMI (-0.18; -0.29, -0.08) and medium-risk (-0.18; -0.33, -0.04) and high-risk (-0.22; -0.42, -0.02) neighbourhoods. CONCLUSIONS Associations between infant feeding practices and childhood BMI may differ between risk groups, implying that overweight prevention strategies should be group-specific.
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Affiliation(s)
- O. Sirkka
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands,Danone Nutricia ResearchUtrechtThe Netherlands
| | - T. Vrijkotte
- Department of Public Health, Academic Medical Centre, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamThe Netherlands
| | - J. Halberstadt
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | | | - T. Hoekstra
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - J. Seidell
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - M. Olthof
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
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Sidorenkov G, van Boven JFM, Hoekstra T, Nijpels G, Hoogenberg K, Denig P. HbA1c response after insulin initiation in patients with type 2 diabetes mellitus in real life practice: Identifying distinct subgroups. Diabetes Obes Metab 2018; 20:1957-1964. [PMID: 29687577 PMCID: PMC6055847 DOI: 10.1111/dom.13332] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/06/2018] [Accepted: 04/19/2018] [Indexed: 12/30/2022]
Abstract
AIMS To identify subgroups of patients with type 2 diabetes mellitus (T2DM) following distinct trajectories of HbA1c after insulin initiation and explore underlying differences in clinical characteristics. MATERIALS AND METHODS A cohort study was conducted in patients with T2DM initiating insulin in 2007-2013 with a follow-up of 2 to 4 years. Data were collected from the Groningen Initiative to Analyze Type 2 Diabetes Treatment (GIANTT) database. The primary outcome was subgroups with different trajectories of HbA1c patterns after insulin initiation, as identified by latent class growth modeling. Differences between subgroups were tested using one-way ANOVA, Kruskal-Wallis or chi-square tests, where appropriate. RESULTS From 1459 patients, three subgroups with distinct HbA1c patterns were identified. Group 1 (8%) initially showed a moderate decrease followed by an increase in HbA1c 2 years later, despite receiving more comedication. Group 2 (84%) showed a stable decrease. Group 3 (8%) had a high initial level of HbA1c and a rapid decline within the first year, followed by a slow increase thereafter. Group 1 patients were on average 6-7 years younger than patients in groups 2 and 3 and were more likely to receive sulfonylureas than Group 3 patients. Group 3 patients had a shorter diabetes duration and were less well-controlled for HbA1c, systolic blood pressure and LDL-cholesterol at insulin initiation. CONCLUSIONS Most patients showed a stable HbA1c response, but one out of six patients showed either a poor response, or a rapid initial response only after insulin initiation. Response patterns were associated with age, diabetes duration and risk-factor controls at the time of insulin initiation.
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Affiliation(s)
- Grigory Sidorenkov
- Department of Clinical Pharmacy and PharmacologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of EpidemiologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Job F. M. van Boven
- Department of Clinical Pharmacy and PharmacologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Trynke Hoekstra
- Center for Human Movement SciencesUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of Health Sciences, Faculty of ScienceAmsterdam Public Health Research Institute, VU University Medical CenterAmsterdamThe Netherlands
| | - Giel Nijpels
- Department of General Practice and Elderly Care MedicineAmsterdam Public Health Research Institute, VU University Medical CenterAmsterdamThe Netherlands
| | - Klaas Hoogenberg
- Department of Internal MedicineMartini HospitalGroningenThe Netherlands
| | - Petra Denig
- Department of Clinical Pharmacy and PharmacologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
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Abonie US, Hoekstra F, Hoekstra T, van der Schans CP, Dekker R, van der Woude LHV, Hettinga FJ. Activity Pacing, Fatigue, Physical Activity And Quality Of Life In Adults With Multiple Sclerosis. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535321.74341.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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