http://repub.eur.nl/res/col/9704/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/31582/ 2012-03-01T00:00:00Z [to follow] Kok, I.M.C.M. de Rosmalen, J.M. van Dillner, J. Arbyn, M. Sasieni, P. Ballegooijen, M. van http://repub.eur.nl/res/pub/31517/ 2012-02-16T00:00:00Z Abstract Background Incidence rates of cutaneous squamous cell carcinoma (SCC) are increasing in many countries, though detailed information is scarce. Objectives To describe detailed trends in incidence rates, relative survival and estimate mortality rates of SCC in the Netherlands. Methods Information on newly diagnosed SCC patients between 1989 and 2008 was obtained from the Netherlands Cancer Registry (NCR). Information of non-melanoma skin cancer (NMSC) mortality was obtained from Statistics Netherlands. European Standardised Rates (ESR) and Estimated Annual Percentage Change (EAPC) were calculated. Incidence rates were fitted to two different models and predicted by the best fitted model. Cohort-based and multivariate survival analyses were performed to assess changes over time. Results The ESR increased from 22.2 to 35.4 per 100,000 inhabitants for males and from 7.8 to 20.5 for females. The EAPC was 6.9% (95% confidence interval: 5.8–8.7) for males and 9.2% (95% CI: 7.5–11.0) for females. Incidence rates increased for all body sites, except for the lips, where a decreasing trend for males was observed. The predicted ESR in 2020 is 46.9 per 100,000 inhabitants for males and 28.7 for females. The 5-year relative survival rate was 92.0% (95% CI: 91.3–92.8) for males and 94.9% (95% CI: 94.0–95.7) for females and remained stable over time. Overall relative survival was better for females, but females with advanced disease had a 30.4 relative excess risk of dying compared to those in stage I. This difference was 9.9 for men. The estimated mortality rate decreased with –1.9% (95% CI: –3.1% to –0.7%) annually. Conclusions Incidence rates of SCC increased rapidly. Relative survival was high, as most SCCs were diagnosed in stage I. Nevertheless, the number of newly diagnosed patients may exceed 11,000 by 2020, emphasising the need to improve methods to prevent skin cancer. Hollestein, L.M. Vries, E. de Nijsten, T.E.C. http://repub.eur.nl/res/pub/30690/ 2011-11-28T00:00:00Z Inleiding. Daling sterfte Gerandomiseerde trials onder bijna 350.000 vrouwen hebben aangetoond dat onder gerandomiseerde en daarna voor borstkankerscreening uitgenodigde vrouwen van 50 jaar en ouder de sterfte aan borstkanker met 25% was gedaald ten opzichte van gerandomiseerde en niet-uitgenodigde groepen vrouwen (1). De Cochrane-groep schreef in 2000 dat de gerandomiseerde trials niet goed waren, maar in de recentere Cochrane reviews kwam men hier op terug (2, 3). Essentiële trial-publicaties waren niet meegenomen (4); er was geen rekening gehouden met geprotocolleerde screening in de controle-groep van de Canadese studie en zelfselectie (5), en de aanvankelijke mate van trial-kwaliteit verdeling (let wel: er werd niet screeningskwaliteit bedoeld) moest afgezwakt worden. Naast gerandomiseerd onderzoek is er klinisch en pathologisch bewijs (6) dat met toenemende groei van de tumor als gevolg van groeifactoren het aantal bloedvaten rondom de tumor toeneemt. De kans op positieve lymfklieren en uitzaaiingen wordt daarmee vergroot, proportioneel naar tumorgrootte (en feitelijk dus proportioneel naar omringende vaatgroei). Het wegnemen van de tumor derhalve indien deze nog klein is, verkleint de kans op uitzaaiingen en daarmee borstkankersterfte. Na deze trials is bevolkingsonderzoek vaak regionaal-gewijs geïmplementeerd; in Finland zijn zelfs geboortecohorten gerandomiseerd tussen vroege en late uitnodiging. Evaluaties van deze implementaties tonen ook in de niet-trial setting borstkanker sterfte-reducties van 37-70% aan voor gescreende vrouwen (7). Koning, H.J. de http://repub.eur.nl/res/pub/22816/ 2011-03-25T00:00:00Z Otto, S.J. Klijs, B. Habbema, J.D.F. Koning, H.J. de Graaf, Y. van der Heine, R.J. http://repub.eur.nl/res/pub/23838/ 2011-03-01T00:00:00Z Objective: When comparing the efficacy of different interventions for cancer patients, there should be certainty that these types are sufficiently different in the way they are actually presented. The aim of the present study is to develop a method for assessing differences between the content of social support groups and experiential-existential therapy groups. Methods: Independent and blind raters assessed video fragments of both intervention types, using a self-developed checklist of five questions. This checklist was first evaluated by a group of experts for appropriateness, importance, and rateability. Results: Three out of the five questions were selected on the basis of these experts' evaluation and on inter-rater reliability. The scores on these questions were used to evaluate five social support groups and six experiential-existential therapy groups for breast cancer patients. According to the independent and blind raters the content of the two intervention forms appeared to be significantly different. Conclusion: The assessment method we developed appeared reliable and valid. Practice implications: Our assessment method is feasible as a check to compare the content of psycho-oncological interventions and can be easily adjusted into a test for other intervention types. Garssen, B. Vos P. Jager Meezenbroek, E. de Klerk, C. de Visser, A. http://repub.eur.nl/res/pub/21331/ 2010-10-19T00:00:00Z Background:Women living with HIV and co-infected with bacterial vaginosis (BV) are at higher risk for transmitting HIV to a partner or newborn. It is poorly understood which bacterial communities constitute BV or the normal vaginal microbiota among this population and how the microbiota associated with BV responds to antibiotic treatment. Methods and Findings: The vaginal microbiota of 132 HIV positive Tanzanian women, including 39 who received metronidazole treatment for BV, were profiled using Illumina to sequence the V6 region of the 16S rRNA gene. Of note, Gardnerella vaginalis and Lactobacillus iners were detected in each sample constituting core members of the vaginal microbiota. Eight major clusters were detected with relatively uniform microbiota compositions. Two clusters dominated by L. iners or L. crispatus were strongly associated with a normal microbiota. The L. crispatus dominated microbiota were associated with low pH, but when L. crispatus was not present, a large fraction of L. iners was required to predict a low pH. Four clusters were strongly associated with BV, and were dominated by Prevotella bivia, Lachnospiraceae, or a mixture of different species. Metronidazole treatment reduced the microbial diversity and perturbed the BV-associated microbiota, but rarely resulted in the establishment of a lactobacilli-dominated microbiota. Conclusions: Illumina based microbial profiling enabled high though-put analyses of microbial samples at a high phylogenetic resolution. The vaginal microbiota among women living with HIV in Sub-Saharan Africa constitutes several profiles associated with a normal microbiota or BV. Recurrence of BV frequently constitutes a different BV-associated profile than before antibiotic treatment. Hummelen, R.B.S. Fernandes, A.D. Macklaim, J.M. Dickson, R.J. Changalucha, J. Gloor, G.B. Reid, G.K. http://repub.eur.nl/res/pub/20620/ 2010-09-01T00:00:00Z Objective: Tai Chi (TC) is an exercise training that is becoming increasingly popular as an intervention for single fall prevention. This meta-analysis was performed to evaluate the efficacy of TC on fall rate, fear of falling and balance in older people. Methods: Randomized controlled trials published between 1988 and January 2009 were included. In the Netherlands (2009) we used random effects models for the analyses, with data reported as incidence rate ratios (IRR) for falls and standardized mean differences (SMD) for fear of falling and balance. Results: Nine trials (representing 2203 participants) were included in the analyses. Compared with exercise controls, TC participants showed significant improvements in fall rates (2 trials included, IRR: 0.51, 95% CI 0.38-0.68) and static balance (2 trials included, SMD: 0.47, 95% CI 0.23-0.72). Compared with non-exercise controls, no improvement was found for TC participants in fall rates (5 trials, IRR: 0.79, 95% CI 0.60-1.03) or static balance (2 trials, SMD: 0.30, 95% CI - 0.50-1.10), but a significant improvement was found for fear of falling (SMD: 0.37, 95% CI = 0.03-0.70). Conclusions: Currently there is insufficient evidence to conclude whether TC is effective in fall prevention, decreasing fear of falling and improving balance in people over age 50 years. Logghe, I.H.J. Verhagen, A.P. Rademaker, A.C.H.J. Bierma-Zeinstra, S.M.A. Rossum, E. van Faber, M.J. Koes, B.W. http://repub.eur.nl/res/pub/20942/ 2010-08-23T00:00:00Z Background: There is increasing evidence that unacylated ghrelin (UAG) improves insulin sensitivity and glucose homeostasis; however, the mechanism for this activity is not fully understood since a UAG receptor has not been discovered. Methodology/Principal Findings: To assess potential mechanisms of UAG action in vivo, we examined rapid effects of UAG on genome-wide expression patterns in fat, muscle and liver of growth hormone secretagogue receptor (GHSR)-ablated mice using microarrays. Expression data were analyzed using Ingenuity Pathways Analysis and Gene Set Enrichment Analysis. Regulation of subsets of these genes was verified by quantitative PCR in an independent experiment. UAG acutely regulated clusters of genes involved in glucose and lipid metabolism in all three tissues, consistent with enhancement of insulin sensitivity. Conclusions/Significance: Fat, muscle and liver are central to the control of lipid and glucose homeostasis. UAG rapidly modulates the expression of metabolically important genes in these tissues in GHSR-deleted mice indicating a direct, GHSRindependent, action of UAG to improve insulin sensitivity and metabolic profile. Delhanty, P.J.D. Sun, Y. Visser, J.A. Kerkwijk, A. Huisman, M. IJcken, W.F.J. van Swagemakers, S.M.A. http://repub.eur.nl/res/pub/21030/ 2010-08-13T00:00:00Z HIV protease inhibitors must penetrate into cells to exert their action. Differences in the intracellular pharmacokinetics of these drugs may explain why some patients fail on therapy or suffer from drug toxicity. Yet, there is no information available on the intracellular levels of HIV protease inhibitors in HIV infected children, which is in part due to the large amount of sample that is normally required to measure the intracellular concentrations of these drugs. Therefore, we developed an ultra-fast and sensitive assay to measure the intracellular concentrations of HIV protease inhibitors in small amounts of peripheral blood mononuclear cells (PBMCs), and determined the intracellular concentrations of lopinavir and ritonavir in HIV infected children. An assay based on matrix-assisted laser desorption/ionization (MALDI) - triple quadrupole mass spectrometry was developed to determine the concentrations of HIV protease inhibitors in 10 μL plasma and 1 × 106 PBMCs. Precisions and accuracies were within the values set by the FDA for bioanalytical method validation. Lopinavir and ritonavir did not accumulate in PBMCs of HIV infected children. In addition, the intracellular concentrations of lopinavir and ritonavir correlated poorly to the plasma concentrations ofthese drugs. MALDI-triple quadrupole mass spectrometry is a new tool for ultra-fast and sensitive determination of drug concentrations which can be used, for example, to assess the intracellular pharmacokinetics of HIV protease inhibitors in HIV infected children. Kampen, J.J.A. van Reedijk, M.L. Gruters, R.A. Burgers, P.C. Dekker, L.J.M. Hartwig, N.G. Ende, I.E. van der Groot, R. de Osterhaus, A.D.M.E. Burger, D.M. Luider, T.M. http://repub.eur.nl/res/pub/20272/ 2010-08-08T00:00:00Z BACKGROUND: Avian influenza (AI) is a public health challenge because of ongoing spread and pandemic potential. Non-pharmaceutical measures are important to prevent the spread of AI and to contain a pandemic. The effectiveness of such measures is largely dependent on the behaviour of the population. Risk perception is a central element in changing behaviour. This study aimed to investigate perceived vulnerability, severity and precautionary behaviour related to AI in the Netherlands during seven consecutive surveys in 2006 - 2007 as well as possible trends in risk perception and self-reported precautionary behaviours. METHODS: Seven web-based surveys were conducted including 3,840 respondents over a one-year period. Time trends were analyzed with linear regression analyses. Multivariate analysis was used to study determinants of precautionary behaviour. RESULTS: While infection with AI was considered a very severe health problem with mean score of 4.57 (scale 1 - 5); perceived vulnerability was much lower, with a mean score of 1.69. While perceived severity remained high, perceived vulnerability decreased slightly during a one-year period covering part of 2006 and 2007. Almost half of the respondents (46%) reported taking one or more preventive measures, with 36% reporting to have stayed away from (wild) birds or poultry. In multivariate logistic regression analysis the following factors were significantly associated with taking preventive measures: time of the survey, higher age, lower level of education, non-Dutch ethnicity, vaccinated against influenza, higher perceived severity, higher perceived vulnerability, higher self efficacy, lower level of knowledge, more information about AI, and thinking more about AI. Self efficacy was a stronger predictor of precautionary behaviour for those who never or seldom think about AI (OR 2.3, 95% CI 1.9 - 2.7), compared to those who think about AI more often (OR 1.5, 95% CI 1.2 - 1.9). CONCLUSIONS: The fact that perceived severity of AI appears to be high and remains so over time offers a good point of departure for more specific risk communications to promote precautionary actions. Such communications should aim at improving knowledge about the disease and preventive actions, and focus on perceived personal vulnerability and self efficacy in taking preventive measures. Zwart, O. de Veldhuijzen, I.K. Richardus, J.H. Brug, J. http://repub.eur.nl/res/pub/20555/ 2010-04-29T00:00:00Z Koning, H.J. de http://repub.eur.nl/res/pub/18676/ 2010-03-01T00:00:00Z The objective of this study was to assess whether the emergency department (ED) injury surveillance systems in Europe are suitable for cross-country comparisons. For this, the ED injury surveillance systems in Austria, Denmark, Greece, Ireland, the Netherlands, Norway and the UK (England, Wales) were considered. Standardised injury incidence and healthcare utilisation indices were calculated and the influence of measurement bias due to data collection and sampling differences, as well as trauma policy and health systems characteristics were assessed. The results showed that there was an over 3-fold variation of the grossly estimated incidence for home and leisure injuries (HLIs), with the highest values observed in England and Greece (111 and 104 per 1000 person years), and the lowest in Ireland and the Netherlands (27 and 48 per 1000 person years). The ranking of countries changed, however, when only injuries with an inherent need for ED treatment were considered (selected radiological verifiable fractures) with Austria topping the table followed by Greece and England. Thus, it is concluded that the naive use of ED injury surveillance systems for cross-country comparisons should be discouraged, as this is subject to measurement bias. Nevertheless, the observed variation in the healthcare utilisation and injury incidence, particularly among children and older people, indicates the potential to reduce the burden of HLI in Europe. Jan Meerding, W. Polinder, S. Lyons, R.A. Petridou, E.T. Toet, H. Beeck, E.F. van Mulder, S. http://repub.eur.nl/res/pub/17187/ 2009-11-11T00:00:00Z Introduction: Child abuse is a serious problem worldwide and can be difficult to detect. Although children who experience the consequences of abuse will probably be treated at an emergency department, detection rates of child abuse at emergency departments remain low. OBJECTIVE: To identify effective interventions applied at emergency departments that significantly increase the detection rate of confirmed cases of child abuse. DESIGN: This review was carried out according to the Cochrane Handbook. Two reviewers individually searched Pubmed, The Cochrane Library, EMBASE, Web of Science, and CINAHL for papers that met the inclusion criteria. RESULTS: Fifteen papers describing interventions were selected and reviewed; four of these were finally included and assessed for quality. In these studies the intervention consisted of a checklist of indicators of risk for child abuse. After implementation, the rate of detected cases of suspected child abuse increased by 180% (weighted mean in 3 studies). The number of confirmed cases of child abuse, reported in two out of four studies, showed no significant increase. CONCLUSIONS: Interventions at emergency departments to increase the detection rate of cases of confirmed child abuse are scarce in the literature. Past study numbers and methodology have been inadequate to show conclusive evidence on effectiveness. Louwers, E.C.F.M. Affourtit, M.J. Moll, H.A. Koning, H.J. de Korfage, I.J. http://repub.eur.nl/res/pub/16539/ 2009-08-20T00:00:00Z The number of female cancer survivors has been rising rapidly. We assessed the occurrence of breast cancer in these survivors over time. We computed incidence of primary breast cancer in two cohorts of female cancer survivors with a first diagnosis of cancer at ages 30+ in the periods 1975–1979 and 1990–1994. Cohorts were followed for 10 years through a population-based cancer registry. Over a period of 15 years, the incidence rate of breast cancer among female cancer survivors increased by 30% (age-standardised rate ratio (RR-adj): 1.30; 95% CI: 1.03–1.68). The increase was significant for non-breast cancer survivors (RR-adj: 1.41, 95% CI: 1.04–2.75). During the study period, the rate of second breast cancer stage II tripled (RR-adj: 3.10, 95% CI: 1.73–5.78). Non-breast cancer survivors had a significantly (P value=0.005) more unfavourable stage distribution (62% stage II and III) than breast cancer survivors (32% stage II and III). A marked rise in breast cancer incidence among female cancer survivors was observed. Research to optimise follow-up strategies for these women to detect breast cancer at an early stage is warranted. Soerjomataram, I. Louwman, W.J. Duijm, L.E.M. Coebergh, J.W.W. http://repub.eur.nl/res/pub/16540/ 2009-08-20T00:00:00Z Soerjomataram, I. Vries, E. de http://repub.eur.nl/res/pub/16543/ 2009-08-20T00:00:00Z Pierik, F.H. Deddens, J.A. Burdorf, A. Muinck Keizer-Schrama, S.M.P.F. de Jong, F.H. de Weber, R.F.A. http://repub.eur.nl/res/pub/12701/ 2009-08-19T00:00:00Z Mackenbach, J.P. http://repub.eur.nl/res/pub/16533/ 2009-08-19T00:00:00Z Mackenbach, J.P. http://repub.eur.nl/res/pub/15480/ 2009-08-17T00:00:00Z Lorant, V. Kunst, A.E. Huisman, M. Costa, G. Mackenbach, J.P. http://repub.eur.nl/res/pub/16357/ 2009-08-17T00:00:00Z Objective The aim of the study is to evaluate whether health inequalities associated with unemployment are comparable across different ethnic groups. Method A random sample of inhabitants of the city of Rotterdam filled out a questionnaire on health and its determinants, with a response of 55.4% (n = 2,057). In a cross-sectional design the associations of unemployment, ethnicity, and individual characteristics with a perceived poor health were investigated with logistic regression analysis. The associations of these determinants with physical and mental health, measured by the Short Form 36 Health Survey, were evaluated with linear regression analyses. Interactions between ethnicity and unemployment were investigated to determine whether associations of unemployment and health differed across ethnic groups. Results Ill health was more common among unemployed persons [odds ratio (OR) 2.6; 95% CI 1.7–3.8] than workers in paid employment. Health inequalities between employed and unemployed persons were largest among native Dutch persons (OR = 3.2) and Surinamese/Antillean persons (OR = 2.6), and smaller in Turkish/Moroccan persons (OR = 1.6) and overseas refugees (OR = 1.6). The proportions of persons with poor health that could be attributed to unemployment were 14, 26, 14, and 13%, respectively. Conclusions Differences in ill health between employed and unemployed persons were less profound in ethnic groups compared to the majority population, but the prevalence of unemployment was much higher in ethnic groups. The population attributable fractions varied between 14 and 28%, supporting the argument that policies for health equity should pay more attention to measures that include persons in the labour market and that prevent workers with ill health from dropping out of the workforce. Schuring, M. Burdorf, A. Kunst, A.E. Voorham, T. Mackenbach, J.P.