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Multidisciplinair zorgmodel in verzorgingshuizen

Marijke Boorsma, Dinnus Frijters, Dirk Knol, Miel Ribbe, Giel Nijpels, Hein van Hout
2012 Huisarts en Wetenschap  
Dit artikel is een bewerkte vertaling van: Boorsma M, Frijters DHM, Knol DL, Ribbe ME, Nijpels G, Van Hout HPJ.  ...  Nijpels, hoogleraar huisartsgeneeskunde. Afdeling Epidemiologie en biostatistiek: D.L. Knol, senior onderzoeker. Afdeling Verpleeghuisgeneeskunde: prof.dr. M.E.  ...  we met de Short Form 12 (SF12) gemeten. 19, 20 De secundaire uitkomsten waren de volgende: Interme z zo Foto: Shutterstock/Jakub Cejpek Samenvatting Boorsma M, Frijters DHM, Knol DL, Ribbe ME, Nijpels  ... 
doi:10.1007/s12445-012-0076-9 fatcat:2aayvzqvmbgexekeizhiro22ry

De effectiviteit van leefstijlinterventies in de eerste lijn

Jeroen Lakerveld, Sandra Bot, Giel Nijpels
2014 Huisarts en Wetenschap  
Hooggecontroleerde onderzoeken (efficacy trials) hebben overtuigend aangetoond dat het mogelijk Samenvatting Lakerveld J, Bot SD, Nijpels G.  ...  Nijpels, hoogleraar huisartsgeneeskunde met speciale aandacht voor diabehet Leefstijl Onderzoek West-Friesland gefinancierd. tense PJ, Dekker JM, et al.  ...  Jeroen Lakerveld, Sandra Bot, Giel Nijpels is om het ontstaan van DM II bij volwassenen met een licht gestoorde glucosetolerantie uit te stellen door middel van een intensief leefstijlprogramma.  ... 
doi:10.1007/s12445-014-0036-7 fatcat:45ro6bapl5cujjsq633hox5sf4

Insulin Sensitivity and Albuminuria: The RISC Study

Stefan Pilz, Femke Rutters, Giel Nijpels, Coen D.A. Stehouwer, Kurt Højlund, John J. Nolan, Beverley Balkau, Jacqueline M. Dekker
2014 Diabetes Care  
OBJECTIVE Accumulating evidence suggests an association between insulin sensitivity and albuminuria, which, even in the normal range, is a risk factor for cardiovascular diseases. We evaluated whether insulin sensitivity is associated with albuminuria in healthy subjects. RESEARCH DESIGN AND METHODS We investigated 1,415 healthy, nondiabetic participants (mean age 43.9 6 8.3 years; 54.3% women) from the RISC (Relationship between Insulin Sensitivity and Cardiovascular Disease) study, of whom
more » ... participated in a follow-up examination after 3 years. At baseline, insulin sensitivity was assessed by hyperinsulinemiceuglycemic clamps, expressed as the M/I value. Oral glucose tolerance test-based insulin sensitivity (OGIS), homeostasis model assessment of insulin resistance (HOMA-IR), and urinary albumin-to-creatinine ratio (UACR) were determined at baseline and follow-up. RESULTS Microalbuminuria (UACR ‡30 mg/g) was present in fewer than 2% at either study visit. After multivariate adjustments, there was no cross-sectional association between UACR and any measure of insulin sensitivity. Neither OGIS nor HOMA-IR was significantly associated with follow-up UACR, but in a multivariate regression analysis, baseline M/I emerged as an independent predictor of UACR at follow-up (b-coefficient 20.14; P = 0.001). CONCLUSIONS In healthy middle-aged adults, reduced insulin sensitivity, assessed by hyperinsulinemic-euglycemic clamp, is continuously associated with a greater risk of increasing albuminuria. This finding suggests that reduced insulin sensitivity either is simply related to or might causally contribute to the initial pathogenesis of albuminuria. Higher levels of albuminuria are associated with an increased risk of mortality and cardiovascular events in patients with diabetes mellitus or arterial hypertension and the general population (1-3). Insights into the pathophysiology of albuminuria are of high clinical relevance since therapeutic interventions to reduce albuminuria are often accompanied by improvements in cardiovascular outcomes (3). Microalbuminuria is also regarded as a marker of a certain form of endothelial dysfunction, but there exists still no clear picture on the direction of the cause and effect relationship (4-6). Alternatively, microalbuminuria and vascular diseases/endothelial dysfunction may also be caused by a common pathophysiologic process (7) .
doi:10.2337/dc13-2573 pmid:24623021 fatcat:zq4ppzz44jfjdiry5usg5tghwm

Identification of drug-related problems of elderly patients discharged from hospital

Jacqueline Hugtenburg, A Ahmad, Ruth Mast, Jacqueline Dekker, Giel Nijpels, Petra Elders
2014 Patient Preference and Adherence  
Drug-related problems (DRP) following hospital discharge are common among elderly patients using multiple drugs for the treatment of chronic diseases. The aim of this study was to investigate the occurrence of DRP in these patients using a specific tool for the identification of DRP by community pharmacists. An observational study involving 340 patients aged over 60 years using at least five prescription drugs and discharged from hospital. The occurrence of DRP was assessed by means of an
more » ... fication tool specifically developed for use by community pharmacists, including a semistructured patient interview and a checklist of common DRP. In total, 992 potential DRP were observed in the 340 patients (mean 2.9 ± 1.7). No drug prescribed but clear indication, an unnecessarily long duration of treatment, dose too low, and incorrect drug selection were the DRP most commonly observed. Ten percent of DRP occurring in 71 patients were drug-drug interactions. The number of DRP was related to the number of drugs prescribed. Frequently occurring DRP found using the patient interview were fear of side effects and no or insufficient knowledge of drug use. Medication of patients discharged from the pulmonary department and of those with type 2 diabetes was particularly associated with occurrence of DRP. Following hospital discharge, DRP occur frequently among elderly patients using five or more drugs for the treatment of chronic disease. The number of DRP increased with the number of drugs used. An important task for community pharmacists is to identify, resolve, and prevent the occurrence of DRP among this patient group. Since DRP are associated with an increased risk of hospital readmissions, morbidity, and mortality, it is very important to develop intervention strategies to resolve and prevent DRP.
doi:10.2147/ppa.s48357 pmid:24523581 pmcid:PMC3920925 fatcat:fv6ueel6rfdxva5hkqu5y7om7q

Improving multidisciplinary collaboration – a case study from the Netherlands

Manon Lette, Marijke Boorsma, Annerieke Stoop, Caroline Baan, Giel Nijpels, Simone De Bruin
2019 International Journal of Integrated Care  
doi:10.5334/ijic.s3592 fatcat:g6fnh6z4snduxmrsj746cghcpq

Validity of self-measured waist circumference in adults at risk of type 2 diabetes and cardiovascular disease

Ana Ayala, Giel Nijpels, Jeroen Lakerveld
2014 BMC Medicine  
Waist circumference (WC) is used to indirectly measure abdominal adipose tissue and the associated risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Because of its easy implementation and low cost, self-measured WC is commonly used as a screening tool. However, discrepancies between self-measured and objectively measured WC may result in misclassification of individuals when using established cut-off values. The aim of this study was to determine the accuracy of
more » ... ured WC in adults at risk of T2DM and/or CVD, and to determine the anthropometric, demographic and behavioural characteristics associated with bias in self-measured WC. Methods: Self-measured and objectively measured WC was obtained from 622 participants (58.4% female; mean age 43.4 ± 5.3 years) in the Hoorn Prevention Study. The associations of gender, age, educational level, body mass index, smoking status, dietary habits, physical activity and sedentary behaviour with the discrepancies between self-measured and objectively measured WC were analysed using independents t-test and one-way ANOVA. Bland-Altman plots were used to plot the agreement between the two measures. Results: On average, self-measured WC was overestimated by 5.98 ± 4.82 cm (P < 0.001). Overestimation was consistent across all subgroups, but was more pronounced in those who were younger and those with lower educational attainment. Conclusions: The results support self-measured WC as a useful tool for large-scale populations and epidemiological studies when objective measurement is not feasible, but overestimation should be taken into account when screening adults at risk of T2DM and/or CVD.
doi:10.1186/preaccept-6850939411325425 pmid:25274418 pmcid:PMC4192531 fatcat:wv6wwisblzbktfba4brejiohpa

MOESM7 of Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort

Roderick Slieker, Amber Heijden, Giel Nijpels, Petra Elders, Leen Hart, Joline Beulens
2019 Figshare  
Additional file 7: Table S4. Unadjusted and adjusted effect sizes of models with HbA1c-CV for each quintile.
doi:10.6084/m9.figshare.11364125 fatcat:7wmuwdh4f5bi5emrcfvudtaiam

MOESM4 of Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort

Roderick Slieker, Amber Heijden, Giel Nijpels, Petra Elders, Leen Hart, Joline Beulens
2019 Figshare  
Additional file 4: Figure S2. Comparison of FG-CV and HbA1c-CV across intervals. a) Median FG-CV across intervals. Line represents smoothed medians. Light blue, fasting glucose, dark blue HbA1c. b) Spearman correlation between FG-CV and HbA1c-CV across intervals. Line represents a linear regression line. c) Percentage of intervals compared to total number of individuals that ended up in a certain quintile, i.e. 100% means all intervals of an individual were assigned to that quintile. d) Overlap between FG-CV quintiles and HbA1c-CV quintiles.
doi:10.6084/m9.figshare.11364101.v1 fatcat:mit73ac37ndojhemtjnarq5wlm

Patient involvement in diabetes care: experiences in nine diabetes care groups

Lidwien Lemmens, Simone De Bruin, Jeroen Struijs, Mieke Rijken, Giel Nijpels, Caroline Baan
2015 International Journal of Integrated Care  
Lidwien Lemmens, Simone de Bruin, Jeroen Struijs, Mieke Rijken, Giel Nijpels and Caroline Baan declare that they have no conflict of interest.  ... 
doi:10.5334/ijic.2207 fatcat:j36ztre5rvd5loo7eelbahaabm

MOESM9 of Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort

Roderick Slieker, Amber Heijden, Giel Nijpels, Petra Elders, Leen 'T Hart, Joline Beulens
2019 Figshare  
Additional file 9: Figure S4. Glucose-lowering treatments across HbA1c-CV quintiles. a–e Percentage of individuals per quintile untreated (a), on metformin only (b), combination of metformin and SU (c), SU monotherapy (d) and insulin (e). f–h Odds ratios of the four highest quintiles versus the lowest quintile across time for (f) metformin (g) sulphonylureas and (h) insulin. Abbreviations: SU, sulphonylureas.
doi:10.6084/m9.figshare.11364137 fatcat:3fc7ouj4ebgm7bpl7a3rifjj7i

SUSTAIN: the overall design of a European project on integrated care for older people

Simone Renate De Bruin, Giel Nijpels, Caroline Baan
2016 International Journal of Integrated Care  
decision-makers to improve care for older people with multiple health and social care needs now and in the future by working towards more patient-centred, prevention-oriented, safe and efficient integrated care provision.
doi:10.5334/ijic.2667 fatcat:u7hrocy2bzcc3c7eta5ytudbaa

Causal beliefs and perceptions of risk for diabetes and cardiovascular disease, The Netherlands, 2007

Liesbeth Claassen, Lidewij Henneman, Giel Nijpels, Jacqueline Dekker, Theresa Marteau, Danielle Timmermans
2011 Preventing Chronic Disease  
Tables Some researchers have argued that perceptions of disease risk are based on matching personal risk factor Liesbeth Claassen, PhD; Lidewij Henneman, PhD; Giel Nijpels, MD, PhD; Jacqueline Dekker,  ... 
pmid:22005623 pmcid:PMC3221572 fatcat:tmraqewlkzcd3hyaczvacwx644

Arterial Stiffness Increases With Deteriorating Glucose Tolerance Status

Ronald M.A. Henry, Piet J. Kostense, Annemieke M.W. Spijkerman, Jacqueline M. Dekker, Giel Nijpels, Robert J. Heine, Otto Kamp, Nico Westerhof, Lex M. Bouter, Coen D.A. Stehouwer
2003 Circulation  
Background-Type 2 diabetes (DM-2) and impaired glucose metabolism (IGM) are associated with an increased cardiovascular disease risk. In nondiabetic individuals, increased arterial stiffness is an important cause of cardiovascular disease. Associations between DM-2 and IGM and arterial stiffness have not been systematically investigated. Methods and Results-In a population-based cohort (nϭ747; 278 with normal glucose metabolism, 168 with IGM, and 301 with DM-2; mean age, 68.5 years), arterial
more » ... iffness was ultrasonically estimated by distensibility and compliance of the carotid, femoral, and brachial arteries and by the carotid elastic modulus. After adjustment for age, sex, and mean arterial pressure, DM-2 was associated with increased carotid, femoral, and brachial stiffness, whereas IGM was associated only with increased femoral and brachial stiffness. Carotid but not femoral or brachial stiffness increased from IGM to DM-2. Standardized ␤s (95% CI) for IGM and DM-2, compared with normal glucose metabolism, were Ϫ0.06 (Ϫ0.23 to 0.10) and Ϫ0.37 (Ϫ0.51 to Ϫ0.23) for carotid distensibility; Ϫ0.02 (Ϫ0.18 to 0.18) and Ϫ0.25 (Ϫ0.40 to Ϫ0.09) for carotid compliance; Ϫ0.05 (Ϫ0.23 to 0.13) and 0.25 (0.10 to 0.40) for carotid elastic modulus; Ϫ0.70 (Ϫ0.89 to Ϫ0.51) and Ϫ0.67 (Ϫ0.83 to Ϫ0.52) for femoral distensibility; and Ϫ0.62 (Ϫ0.80 to Ϫ0.44) and Ϫ0.79 (Ϫ0.94 to Ϫ0.63) for femoral compliance. The brachial artery followed a pattern similar to that of the femoral artery. Increases in stiffness indices were explained by decreases in distension, increases in pulse pressure, an increase in carotid intima-media thickness, and, for the femoral artery, a decrease in diameter. Hyperglycemia or hyperinsulinemia explained only 30% of the arterial changes associated with glucose tolerance. Adjustment for conventional cardiovascular risk factors did not affect these findings. Conclusions-IGM and DM-2 are associated with increased arterial stiffness. An important part of the increased stiffness occurs before the onset of DM-2 and is explained neither by conventional cardiovascular risk factors nor by hyperglycemia or hyperinsulinemia.
doi:10.1161/01.cir.0000065222.34933.fc pmid:12695300 fatcat:ac72mfe4znbjhh4yxbtsmwmh3i

Validity of self-measured waist circumference in adults at risk of type 2 diabetes and cardiovascular disease

Ana María Contardo Ayala, Giel Nijpels, Jeroen Lakerveld
2014 BMC Medicine  
Waist circumference (WC) is used to indirectly measure abdominal adipose tissue and the associated risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Because of its easy implementation and low cost, self-measured WC is commonly used as a screening tool. However, discrepancies between self-measured and objectively measured WC may result in misclassification of individuals when using established cut-off values. The aim of this study was to determine the accuracy of
more » ... ured WC in adults at risk of T2DM and/or CVD, and to determine the anthropometric, demographic and behavioural characteristics associated with bias in self-measured WC. Methods: Self-measured and objectively measured WC was obtained from 622 participants (58.4% female; mean age 43.4 ± 5.3 years) in the Hoorn Prevention Study. The associations of gender, age, educational level, body mass index, smoking status, dietary habits, physical activity and sedentary behaviour with the discrepancies between self-measured and objectively measured WC were analysed using independents t-test and one-way ANOVA. Bland-Altman plots were used to plot the agreement between the two measures. Results: On average, self-measured WC was overestimated by 5.98 ± 4.82 cm (P < 0.001). Overestimation was consistent across all subgroups, but was more pronounced in those who were younger and those with lower educational attainment. Conclusions: The results support self-measured WC as a useful tool for large-scale populations and epidemiological studies when objective measurement is not feasible, but overestimation should be taken into account when screening adults at risk of T2DM and/or CVD.
doi:10.1186/s12916-014-0170-x pmid:25274418 pmcid:PMC4192531 fatcat:gridlx73z5fzpp2rkwryl4zjfm

Association between Social Network Characteristics and Lifestyle Behaviours in Adults at Risk of Diabetes and Cardiovascular Disease

Sandra D. Bot, Joreintje D. Mackenbach, Giel Nijpels, Jeroen Lakerveld, Yue Wang
2016 PLoS ONE  
Objectives In this exploratory study we examined the associations between several social network characteristics and lifestyle behaviours in adults at increased risk of diabetes and cardiovascular diseases. In addition, we explored whether similarities in lifestyle between individuals and their network members, or the level of social support perceived by these individuals, could explain these associations. Methods From the control group of the Hoorn Prevention Study, participants with high and
more » ... ow educational attainment were approached for a structured interview between April and August 2010. Inclusion was stopped when fifty adults agreed to participate. Participants and a selection of their network members (e.g. spouses, best friends, neighbours, colleagues) completed a questionnaire on healthy lifestyle that included questions on fruit and vegetable intake, daily physical activity and leisure-time sedentary behaviour. We first examined associations between network characteristics and lifestyle using regression analyses. Second, we assessed associations between network characteristics and social support, social support and lifestyle, and compared the participants' lifestyles to those of their network members using concordance correlation coefficients. Results Fifty adults (50/83 x 100 = 62% response) and 170 of their network members (170/192 x 100 = 89% response) participated in the study. Individuals with more close-knit relationships, more friends who live nearby, and a larger and denser network showed higher levels of vegetable consumption and physical activity, and lower levels of sedentary behaviour. Perceived social norms or perceived support for behavioural change were not related to PLOS ONE | Conclusions Study results suggest that adults with a larger and denser social network have a healthier lifestyle. Underlying mechanisms for these associations should be further explored, as the current results suggest a minimal role for social support and modelling by network members. Social Network Characteristics and Lifestyle Behaviours PLOS ONE |
doi:10.1371/journal.pone.0165041 pmid:27798709 pmcid:PMC5087858 fatcat:xpshkahcqjev7l2j7etek3qhie
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