13 results on '"Denig, A."'
Search Results
2. Monte Carlo–Informed Decay Heat Model for Cermet LEU-NTP Systems.
- Author
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Denig, Andrew and Eades, Michael
- Abstract
Two methodologies for performing decay heat analysis with Monte Carlo simulations were developed and implemented on a representative nuclear thermal propulsion (NTP) system. This paper presents the underlying theory, discusses the methodology, and states the key results. This work investigated the importance of utilizing a time-dependent Q-value for fission in NTP systems due to their short burn time. Two approaches for deriving the Q-value were taken: one based on deconvolving the fission rate from the reactor power to yield the rate of fission energy deposition, and the other based on the convergence of the fission product decay power during a long burn. The fission product decay power method is hypothesized to be the more accurate representation of an NTP system as it captures more of the underlying physics occurring during burnup, such as fission product transmutation. The calculated Q-values were employed to derive decay power profiles that were compared to the current state-of-the-art NTP decay power model. According to these new models, it is shown that the cooling requirements for decay heat removal calculated with the state-of-the-art model differ from the developed methods by as much as 23.3%. There exists a need to experimentally validate, and by extension improve, the proposed methods to better understand the nature of decay heat production in NTP systems. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
3. Coping with adverse drug events in patients with heart failure
- Author
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Adelita V. Ranchor, Petra Denig, K. van der Meer, Klaas H. Groenier, Flora M. Haaijer-Ruskamp, R.H.E. De Smedt, Tiny Jaarsma, Science in Healthy Ageing & healthcaRE (SHARE), Ethical, Legal, Social Issues in Genetics (ELSI), Health Psychology Research (HPR), Methods in Medicines evaluation & Outcomes research (M2O), and Life Course Epidemiology (LCE)
- Subjects
Male ,NONADHERENCE ,Coping (psychology) ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,SYMPTOMS ,STRATEGIES ,media_common.quotation_subject ,MEDLINE ,QUESTIONNAIRE ,perception ,Access to Information ,Social support ,ADHERENCE ,Bayesian multivariate linear regression ,Perception ,Surveys and Questionnaires ,ERECTILE DYSFUNCTION ,Adaptation, Psychological ,MANAGEMENT ,Medicine ,Humans ,Path analysis (statistics) ,Psychiatry ,Applied Psychology ,media_common ,Aged ,Heart Failure ,ILLNESS REPRESENTATIONS ,HYPERTENSION ,business.industry ,Information seeking ,Public Health, Environmental and Occupational Health ,PRIMARY-CARE ,Social Support ,Cardiovascular Agents ,General Medicine ,General Chemistry ,medicine.disease ,coping ,Heart failure ,Patient Compliance ,adverse drug events ,Female ,medication beliefs ,business ,Clinical psychology - Abstract
This study describes coping strategies that patients with heart failure (HF) use to manage adverse drug events (ADEs). The included coping strategies were social support seeking, information seeking, non-adherence and taking alleviating medication. The role of beliefs about medication and ADE perceptions in explaining these coping strategies was assessed using the Self-Regulation Model. We performed a cross-sectional study including 250 HF patients who experienced an ADE. Patients completed validated questionnaires assessing their coping strategies, ADE perceptions and medication beliefs. Social support (60%) and information seeking (32%) were the most commonly used strategies to cope with ADEs. Nonadherence was reported by 7% of the patients. Multivariate linear regression analysis showed that demographics, clinical factors and medication beliefs explained only a small amount of the variance in coping strategies, whereas ADE perceptions explained a substantial amount of variance. Path analysis showed that patients' perceptions about the timeline, consequences and controllability of ADEs by the health care provider were directly related to their coping behaviour. The effect of patients' medication beliefs on their coping strategies was consistent with mediation through their ADE perceptions. Our results support the value of the Self-Regulation Model in understanding patients' coping behaviour with regard to ADEs.
- Published
- 2012
4. Pharmacy-based predictors of non-persistence with and non-adherence to statin treatment among patients on oral diabetes medication in the Netherlands.
- Author
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Alfian, Sofa D., Worawutputtapong, Pawida, Schuiling-Veninga, Catharina C. M., van der Schans, Jurjen, Bos, Jens H. J., Hak, Eelko, and Denig, Petra
- Subjects
TREATMENT of diabetes ,PEOPLE with diabetes - Abstract
Aims: To evaluate statin non-persistence and non-adherence as discrete processes in diabetes patients, and identify pharmacy-based predictors of these processes in the first year after statin initiation.Methods: We conducted a retrospective cohort study of statin initiators using a pharmacy database. Persistence and adherence were measured in the first, second and third year. Non-persistence was defined as a gap >180 days. Non-adherence was calculated in persistent patients and defined as a medication possession ratio <80%. Cox regression hazard ratios (HRs) and logistic regression odds ratios (ORs) were assessed for sociodemographic and medication-related factors as possible predictors.Results: Of 12,741 initiators, 20.0% were non-persistent in the first year, while 9.0% and 7.5% were non-persistent in the second and third years. Non-adherence in persistent patients increased from 13.4% in the first to 15.6% and 18.1% in the second and third years. Predictors of non-persistence were female gender (HR: 1.10; 95% CI: 1.01-1.19), older age (HR: 1.52; 95% CI: 1.31-1.75), primary prevention (HR: 1.10; 95% CI: 1.00-1.20), initiating on low dose (HR: 1.44; 95% CI: 1.07-1.94) or standard dose (HR: 1.56; 95% CI: 1.16-2.10), and no cardiovascular co-medication (HR: 1.19; 95% CI: 1.07-1.33), while patients with four or more other medications were more likely to be persistent. Age <50 years (OR: 1.47; 95% CI: 1.22-1.77), low socioeconomic status (OR: 1.27; 95% CI: 1.12-1.45) and primary prevention (OR: 1.21; 95% CI: 1.07-1.38) were predictors of non-adherence, while females were more likely to be adherent (OR: 0.87; 95% CI: 0.77-0.98).Conclusion: Non-persistence was the foremost problem in the first year after statin initiation, while non-adherence in persistent patients increased in the second and third years. Pharmacy-based predictors of statin non-persistence were different from predictors of non-adherence among persistent patients. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
5. Predictors of HbA1c levels in patients initiating metformin.
- Author
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Martono, Doti P., Hak, Eelko, Lambers Heerspink, Hiddo, Wilffert, Bob, and Denig, Petra
- Subjects
GLYCOSYLATED hemoglobin ,METFORMIN ,GLYCEMIC control ,HYPOGLYCEMIC agents ,LONGITUDINAL method ,TYPE 2 diabetes - Abstract
Objective: The aim was to assess demographic and clinical factors as predictors of short (6 months) and long term (18 months) HbA1c levels in diabetes patients initiating metformin treatment.Research Design and Methods: We conducted a cohort study including type 2 diabetes patients who received their first metformin prescription between 2007 and 2013 in the Groningen Initiative to Analyze Type 2 Diabetes Treatment (GIANTT) database. The primary outcome was HbA1c level at follow-up adjusted for baseline HbA1c; the secondary outcome was failing to achieve the target HbA1c level of 53 mmol/mol. Associations were analyzed by linear and logistic regression. Multiple imputation was used for missing data. Additional analyses stratified by dose and adherence level were conducted.Results: The cohort included 6050 patients initiating metformin. Baseline HbA1c at target consistently predicted better HbA1c outcomes. Longer diabetes duration and lower total cholesterol level at baseline were predictors for higher HbA1c levels at 6 months. At 18 months, cholesterol level was not a predictor. Longer diabetes duration was also associated with not achieving the target HbA1c at follow-up. The association for longer diabetes duration was especially seen in patients starting on low dose treatment. No consistent associations were found for comorbidity and comedication.Conclusions: Diabetes duration was a relevant predictor of HbA1c levels after 6 and 18 months of follow-up in patients initiating metformin treatment. Given the study design, no causal inference can be made. Our study suggests that prompt treatment intensification may be needed in patients who have a longer diabetes duration at treatment initiation. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
6. Adherence to standard-dose or low-dose statin treatment and low-density lipoprotein cholesterol response in type 2 diabetes patients.
- Author
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de Vries, F.M., Voorham, J., Hak, E., and Denig, P.
- Subjects
LOW density lipoproteins ,TYPE 2 diabetes ,STATINS (Cardiovascular agents) ,REGRESSION analysis ,CHOLESTEROL ,DIABETES ,BLOOD lipoproteins ,ANTILIPEMIC agents ,COMPARATIVE studies ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,EVALUATION research ,RELATIVE medical risk ,RETROSPECTIVE studies - Abstract
Objective: To determine the association between adherence, dose and low-density lipoprotein (LDL) cholesterol response in patients with type 2 diabetes initiating statin treatment.Research Design and Methods: This cohort study was performed using data for 2007-2012 from the Groningen Initiative to Analyse Type 2 Diabetes Treatment (GIANTT) database. The association between adherence to a standard-dose statin and LDL cholesterol response was assessed using linear regression, adjusting for covariates. The effect of low-dose versus standard-dose was assessed in a propensity-score matched cohort. Adherence rates, defined as the proportion of days covered (PDC), were estimated between statin initiation and LDL outcome measurement.Main Outcome Measure: LDL cholesterol level at follow-up.Results: The effect of adherence on LDL cholesterol response, measured in 2160 patients, was dependent on the baseline LDL cholesterol level. For patients with a baseline LDL cholesterol of 3.7 mmol/l and an adherence rate of 80%, a 40% reduction in LDL cholesterol was predicted. In the matched sample of 1144 patients, the treatment dose showed a difference in impact on the outcome for adherence rates higher than 50%. It was estimated that a patient with a baseline LDL cholesterol of 3.7 mmol/l will need an adherence rate of at least 76% on low-dose and 63% on standard-dose treatment to reach the LDL cholesterol target of 2.5 mmol/l.Limitations: Adherence was measured as the PDC, which is known to overestimate actual adherence. Also, we were not able to adjust for lifestyle factors.Conclusions: We determined the concurrent effect of treatment adherence and dose on LDL cholesterol outcomes. Given the adherence levels seen in clinical practice, diabetes patients initiating statin treatment are at high risk of not reaching the recommended cholesterol target, especially when they start on a low-dose statin. [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF
7. Does a cardiovascular event change adherence to statin treatment in patients with type 2 diabetes? A matched cohort design.
- Author
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de Vries, F.M., Denig, P., Vegter, S., Bos, H.J., Postma, M.J., and Hak, E.
- Subjects
- *
STATINS (Cardiovascular agents) , *CARDIOVASCULAR diseases , *PEOPLE with diabetes , *PATIENT compliance , *CALCIUM antagonists - Abstract
The article offers information on a study conducted by the authors related type 2 diabetes patients agreeing to undergo statin treatment after having a cardiovascular event. Topics discussed include patients willing to take statin after cardiovascular event, more use of nitrates and calcium antagonists during start of statin treatment and data related to medicines given during hospitalization not part of the study.
- Published
- 2015
- Full Text
- View/download PDF
8. Coping with adverse drug events in patients with heart failure: Exploring the role of medication beliefs and perceptions.
- Author
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De Smedt, R.H., Jaarsma, T., Ranchor, A.V., van der Meer, K., Groenier, K.H., Haaijer-Ruskamp, F.M., and Denig, P.
- Subjects
PSYCHOLOGICAL adaptation ,DRUGS ,DRUG side effects ,HEALTH attitudes ,PSYCHOLOGY of cardiac patients ,HEART failure ,RESEARCH methodology ,PATIENT compliance ,PSYCHOLOGICAL tests ,QUESTIONNAIRES ,REGRESSION analysis ,RESEARCH funding ,SCALE analysis (Psychology) ,SELF-management (Psychology) ,STRUCTURAL equation modeling ,CROSS-sectional method ,RESEARCH methodology evaluation ,PATIENTS' attitudes ,DESCRIPTIVE statistics - Abstract
This study describes coping strategies that patients with heart failure (HF) use to manage adverse drug events (ADEs). The included coping strategies were social support seeking, information seeking, non-adherence and taking alleviating medication. The role of beliefs about medication and ADE perceptions in explaining these coping strategies was assessed using the Self-Regulation Model. We performed a cross-sectional study including 250 HF patients who experienced an ADE. Patients completed validated questionnaires assessing their coping strategies, ADE perceptions and medication beliefs. Social support (60%) and information seeking (32%) were the most commonly used strategies to cope with ADEs. Non-adherence was reported by 7% of the patients. Multivariate linear regression analysis showed that demographics, clinical factors and medication beliefs explained only a small amount of the variance in coping strategies, whereas ADE perceptions explained a substantial amount of variance. Path analysis showed that patients’ perceptions about the timeline, consequences and controllability of ADEs by the health care provider were directly related to their coping behaviour. The effect of patients’ medication beliefs on their coping strategies was consistent with mediation through their ADE perceptions. Our results support the value of the Self-Regulation Model in understanding patients’ coping behaviour with regard to ADEs. [ABSTRACT FROM PUBLISHER]
- Published
- 2012
- Full Text
- View/download PDF
9. Between a Rock and a Soft Place.
- Author
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Denig, StephenJ.
- Subjects
- *
CATHOLICS , *UNIVERSITIES & colleges , *CHURCH buildings ,TEACHINGS of Jesus Christ - Abstract
Catholic colleges and universities are caught between two competing pressures. On the one side the church hierarchy, especially the Vatican, wants to make certain that these institutions of higher learning remain faithful to the intellectual tradition and the teachings of the church. On the other side these institutions exist in a postmodern world where relativity and individuality are the norm. This paper proposes to examine how Catholic colleges and universities struggle to remain faithful to the rock of St. Peter (the Vatican) in a postmodern world where norms are flexible and soft. In order to accomplish this, this paper will first examine the efforts by the Vatican to strengthen the Catholic identity of these institutions and their fidelity to the Catholic tradition. Secondly, the paper will examine what is meant by postmodernism. Finally, the author will suggest how Catholic colleges and universities can find the balance between these competing pressures. [ABSTRACT FROM PUBLISHER]
- Published
- 2012
- Full Text
- View/download PDF
10. Public Support for Religious Education in the Nineteenth-century United States.
- Author
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Denig, Stephen J.
- Subjects
- *
RELIGIOUS education , *CHURCH schools , *PUBLIC schools , *PUBLIC support , *NINETEENTH century - Abstract
The purpose of this paper is to examine the three overlapping movements during the nineteenth century that sought to provide public support for religious education. The first movement sought to fund denominational schools directly from public revenues. These publicly supported denominational schools received funds from the state in proportion to the number of students they enrolled. The second movement tried to establish common non-denominational religious schools. These non-denominational religious public schools were supported by the Protestant majority, though opposed by Catholics and Lutherans. In the third movement, the religious public schools, attempted to create schools that were non-denominational during the class hours hut were denominational outside class hours. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
11. Discipline in Public and Religious Elementary and Secondary Schools A Comparative Analysis.
- Author
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Denig, Stephen
- Abstract
The attitude of teachers toward pupil control can be conceptualized as a continuum ranging from custodial to humanistic. Previous studies have found that, in general, secondary-school teachers have a more custodial attitude toward pupil control than do primary-school teachers; public-school teachers have a more custodial attitude than do religious-school teachers. Using The Pupil Control Ideology Form (Willower, Eidell, & Hoy, 1967), this research studied 405 teachers from 40 schools in the Middle Atlantic region. This sample was divided evenly among public primary, public secondary, religious primary, and religious secondary schools. Findings indicate that secondary-school teachers are the more custodial, but no significant difference is noted between the ideologies of public-school teachers and religious-school teachers. An interaction effect was found—public-school teachers on the primary level were the least custodial; public-school teachers on the secondary level are most custodial; the difference in attitude between primary and secondary teachers in religious schools is insignificant. I propose several reasons for this interaction effect. [ABSTRACT FROM PUBLISHER]
- Published
- 1999
- Full Text
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12. Inconsistent prescribing behaviour by physicians: Its effect on the validity of written case simulations.
- Author
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Denig, Petra and Rethans, Jan-Joost
- Published
- 1996
- Full Text
- View/download PDF
13. Catholic Schools Still Make A Difference: Ten Years of Research 1991-2000 (Book).
- Author
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Denig, Stephen J.
- Subjects
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CATHOLIC schools , *NONFICTION - Abstract
Reviews the book "Catholic Schools Still Make a Difference: Ten Years of Research 1991-2000," by Thomas Hunt, Ellis Joseph and Ronald Nuzzi.
- Published
- 2003
- Full Text
- View/download PDF
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