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2. Stroke Etiology and Thrombus Computed Tomography Characteristics in Patients With Acute Ischemic Stroke

Author

Nikki Boodt, Kars C.J. Compagne, Bruna G. Dutra, Noor Samuels, Manon L. Tolhuisen, Heitor C.B.R. Alves, Manon Kappelhof, Geert J. Lycklama à Nijeholt, Henk. A. Marquering, Charles B.L.M. Majoie, Hester F. Lingsma, Diederik W.J. Dippel, Aad van der Lugt, Yvo Roos, Robert van Oostenbrugge, Wim van Zwam, Jelis Boiten, Jan Albert Vos, Ivo Jansen, Maxim Mulder, Robert-Jan Goldhoorn, Wouter Schonewille

Published
2020
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4. The LIFESTYLE study: costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial

Author

Koks Carolien AM, Brinkhuis Egbert A, Broekmans Frank J, Nap Annemiek W, van Kasteren Yvonne M, Schierbeek Jaap M, Bouckaert Peter XJM, Oosterhuis Gerrit JE, Kaaijk Eugenie M, Klijn Nicole F, Maas Jacques WM, van der Veen Fulco, Stolk Ronald P, Macklon Nick S, Hompes Peter GA, Kuchenbecker Walter KH, Bemelmans Wanda JE, Land Jolande A, Bolster Johanna HT, ter Bogt Nancy CW, Groen Henk, Mutsaerts Meike AQ, Burggraaff Jan M, Blankhart Adrienne S, Perquin Denise AM, Gerards Marie H, Mulder Robert JAB, Gondrie Ed TCM, Mol Ben WJ, and Hoek Annemieke

Subjects
Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract

Abstract Background In the Netherlands, 30% of subfertile women are overweight or obese, and at present there is no agreement on fertility care for them. Data from observational and small intervention studies suggest that reduction of weight will increase the chances of conception, decrease pregnancy complications and improve perinatal outcome, but this has not been confirmed in randomised controlled trials. This study will assess the cost and effects of a six-months structured lifestyle program aiming at weight reduction followed by conventional fertility care (intervention group) as compared to conventional fertility care only (control group) in overweight and obese subfertile women. We hypothesize that the intervention will decrease the need for fertility treatment, diminish overweight-related pregnancy complications, and will improve perinatal outcome. Methods/Design Multicenter randomised controlled trial in subfertile women (age 18-39 year) with a body mass index between 29 and 40 kg/m2. Exclusion criteria are azoospermia, use of donor semen, severe endometriosis, premature ovarian failure, endocrinopathies or pre-existent hypertensive disorders. In the intervention group the aim is a weight loss of at least 5% to10% in a six-month period, to be achieved by the combination of a diet, increase of physical activity and behavioural modification. After six months, in case no conception has been achieved, these patients will start fertility treatment according to the Dutch fertility guidelines. In the control group treatment will be started according to Dutch fertility guidelines, independently of the patient's weight. Outcome measures and analysis The primary outcome measure is a healthy singleton born after at least 37 weeks of gestation after vaginal delivery. Secondary outcome parameters including pregnancy outcome and complications, percentage of women needing fertility treatment, clinical and ongoing pregnancy rates, body weight, quality of life and costs. Data will be analysed according to the intention to treat principle, and cost-effectiveness analysis will be performed to compare the costs and health effects in the intervention and control group. Discussion The trial will provide evidence for costs and effects of a lifestyle intervention aiming at weight reduction in overweight and obese subfertile women and will offer guidance to clinicians for the treatment of these patients. Trial registration Dutch Trial Register NTR1530

Published
2010
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5. Cost-effectiveness analysis of lifestyle intervention in obese infertile women

Author

Van Oers, Anne M., Mutsaerts, Meike A Q, Burggraaff, Jan M., Kuchenbecker, Walter K H, Perquin, Denise A M, Koks, Carolien A M, van Golde, R., Kaaijk, Eugenie M, Schierbeek, Jaap M., Klijn, Nicole F., Van Kasteren, Yvonne M., Land, Jolande A, Mol, B. W J, Hoek, A., Groen, H., Oosterhuis, G. J.E., Broekmans, F. J., Vogel, Niels E A, Lambalk, Cornelis B., Verberg, Marieke F G, Mercelina, Patricia E A M, van der Veen, F, Nap, Annemiek W., Gondrie, Ed T C M, Mulder, Robert J A B, Bruin, Jacob P, Reproductive Origins of Adult Health and Disease (ROAHD), Methods in Medicines evaluation & Outcomes research (M2O), Value, Affordability and Sustainability (VALUE), Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), ACS - Atherosclerosis & ischemic syndromes, Plastic, Reconstructive and Hand Surgery, Afdeling Onderwijs FHML, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), and RS: GROW - R4 - Reproductive and Perinatal Medicine

Subjects
Male, obesity, Cost effectiveness, Cost-Benefit Analysis, Overweight, Body Mass Index, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Obstetrics and Gynaecology, 030212 general & internal medicine, Birth Rate, Netherlands, Family Characteristics, OUTCOMES, 030219 obstetrics & reproductive medicine, Obstetrics, SUBFERTILE, Rehabilitation, Obstetrics and Gynecology, Cost-effectiveness analysis, scenario analysis, Weight Reduction Programs, PREGNANCY, Female, medicine.symptom, Live birth, infertility, Infertility, Female, Adult, Infertility, medicine.medical_specialty, Patient Dropouts, Reproductive medicine, WEIGHT-LOSS, Fertilization in Vitro, Direct Service Costs, 03 medical and health sciences, DELIVERY, Ovulation Induction, Intervention (counseling), Weight Loss, medicine, Journal Article, Humans, Infant Health, FERTILITY TREATMENT, Healthy Lifestyle, cost-effectiveness, Infertility, Male, COUPLES, Cryopreservation, OVERWEIGHT, business.industry, lifestyle intervention, LIVE BIRTH, Embryo Transfer, medicine.disease, BODY-MASS INDEX, Reproductive Medicine, anovulation, Physical therapy, Lost to Follow-Up, business, Follow-Up Studies
Abstract

STUDY QUESTION What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? SUMMARY ANSWER Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint. WHAT IS KNOWN ALREADY In infertile couples, obesity decreases conception chances. We previously showed that lifestyle intervention prior to infertility treatment in obese infertile women did not increase the healthy singleton vaginal live birth rate at term, but increased natural conceptions, especially in anovulatory women. Cost-effectiveness analyses could provide relevant additional information to guide decisions regarding offering a lifestyle intervention to obese infertile women. STUDY DESIGN, SIZE, DURATION The cost-effectiveness of lifestyle intervention preceding infertility treatment compared to prompt infertility treatment was evaluated based on data of a previous RCT, the LIFEstyle study. The primary outcome for effectiveness was the vaginal birth of a healthy singleton at term within 24 months after randomization (the healthy live birth rate). The economic evaluation was performed from a hospital perspective and included direct medical costs of the lifestyle intervention, infertility treatments, medication and pregnancy in the intervention and control group. In addition, we performed exploratory cost-effectiveness analyses of scenarios with additional effectiveness outcomes (overall live birth within 24 months and overall live birth conceived within 24 months) and of subgroups, i.e. of ovulatory and anovulatory women, women

Published
2017
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6. Cost-effectiveness analysis of lifestyle intervention in obese infertile women

Author

MS VPG/Gynaecologie, Circulatory Health, Child Health, Van Oers, Anne M., Mutsaerts, Meike A Q, Burggraaff, Jan M., Kuchenbecker, Walter K H, Perquin, Denise A M, Koks, Carolien A M, van Golde, R., Kaaijk, Eugenie M, Schierbeek, Jaap M., Klijn, Nicole F., Van Kasteren, Yvonne M., Land, Jolande A, Mol, B. W J, Hoek, A., Groen, H., Oosterhuis, G. J.E., Broekmans, F. J., Vogel, Niels E A, Lambalk, Cornelis B., Verberg, Marieke F G, Mercelina, Patricia E A M, van der Veen, F, Nap, Annemiek W., Gondrie, Ed T C M, Mulder, Robert J A B, Bruin, Jacob P, behalf of the LIFEstyle study group, MS VPG/Gynaecologie, Circulatory Health, Child Health, Van Oers, Anne M., Mutsaerts, Meike A Q, Burggraaff, Jan M., Kuchenbecker, Walter K H, Perquin, Denise A M, Koks, Carolien A M, van Golde, R., Kaaijk, Eugenie M, Schierbeek, Jaap M., Klijn, Nicole F., Van Kasteren, Yvonne M., Land, Jolande A, Mol, B. W J, Hoek, A., Groen, H., Oosterhuis, G. J.E., Broekmans, F. J., Vogel, Niels E A, Lambalk, Cornelis B., Verberg, Marieke F G, Mercelina, Patricia E A M, van der Veen, F, Nap, Annemiek W., Gondrie, Ed T C M, Mulder, Robert J A B, Bruin, Jacob P, and behalf of the LIFEstyle study group

Published
2017

7. Randomized trial of a lifestyle program in obese infertile women

Author

Mutsaerts, Meike A Q, Van Oers, Anne M., Groen, Henk, Burggraaff, Jan M., Kuchenbecker, Walter K H, Perquin, Denise A M, Koks, Carolien A M, Van Golde, Ron, Kaaijk, Eugenie M., Schierbeek, Jaap M., Oosterhuis, Gerrit J E, Broekmans, Frank J., Bemelmans, Wanda J E, Lambalk, Cornelis B., Verberg, Marieke F G, Van Der Veen, Fulco, Klijn, Nicole F., Mercelina, Patricia E A M, Van Kasteren, Yvonne M., Nap, Annemiek W., Brinkhuis, Egbert A., Vogel, Niels E A, Mulder, Robert J A B, Gondrie, Ed T C M, De Bruin, Jan P., Sikkema, J. Marko, De Greef, Mathieu H G, Ter Bogt, Nancy C W, Land, Jolande A., Mol, Ben W J, Hoek, Annemieke, Mutsaerts, Meike A Q, Van Oers, Anne M., Groen, Henk, Burggraaff, Jan M., Kuchenbecker, Walter K H, Perquin, Denise A M, Koks, Carolien A M, Van Golde, Ron, Kaaijk, Eugenie M., Schierbeek, Jaap M., Oosterhuis, Gerrit J E, Broekmans, Frank J., Bemelmans, Wanda J E, Lambalk, Cornelis B., Verberg, Marieke F G, Van Der Veen, Fulco, Klijn, Nicole F., Mercelina, Patricia E A M, Van Kasteren, Yvonne M., Nap, Annemiek W., Brinkhuis, Egbert A., Vogel, Niels E A, Mulder, Robert J A B, Gondrie, Ed T C M, De Bruin, Jan P., Sikkema, J. Marko, De Greef, Mathieu H G, Ter Bogt, Nancy C W, Land, Jolande A., Mol, Ben W J, and Hoek, Annemieke

Published
2016

8. Randomized trial of a lifestyle program in obese infertile women

Author

MS VPG/Gynaecologie, Circulatory Health, Child Health, HAG Netwerken, Epidemiology & Health Economics, Mutsaerts, Meike A Q, Van Oers, Anne M., Groen, Henk, Burggraaff, Jan M., Kuchenbecker, Walter K H, Perquin, Denise A M, Koks, Carolien A M, Van Golde, Ron, Kaaijk, Eugenie M., Schierbeek, Jaap M., Oosterhuis, Gerrit J E, Broekmans, Frank J., Bemelmans, Wanda J E, Lambalk, Cornelis B., Verberg, Marieke F G, Van Der Veen, Fulco, Klijn, Nicole F., Mercelina, Patricia E A M, Van Kasteren, Yvonne M., Nap, Annemiek W., Brinkhuis, Egbert A., Vogel, Niels E A, Mulder, Robert J A B, Gondrie, Ed T C M, De Bruin, Jan P., Sikkema, J. Marko, De Greef, Mathieu H G, Ter Bogt, Nancy C W, Land, Jolande A., Mol, Ben W J, Hoek, Annemieke, MS VPG/Gynaecologie, Circulatory Health, Child Health, HAG Netwerken, Epidemiology & Health Economics, Mutsaerts, Meike A Q, Van Oers, Anne M., Groen, Henk, Burggraaff, Jan M., Kuchenbecker, Walter K H, Perquin, Denise A M, Koks, Carolien A M, Van Golde, Ron, Kaaijk, Eugenie M., Schierbeek, Jaap M., Oosterhuis, Gerrit J E, Broekmans, Frank J., Bemelmans, Wanda J E, Lambalk, Cornelis B., Verberg, Marieke F G, Van Der Veen, Fulco, Klijn, Nicole F., Mercelina, Patricia E A M, Van Kasteren, Yvonne M., Nap, Annemiek W., Brinkhuis, Egbert A., Vogel, Niels E A, Mulder, Robert J A B, Gondrie, Ed T C M, De Bruin, Jan P., Sikkema, J. Marko, De Greef, Mathieu H G, Ter Bogt, Nancy C W, Land, Jolande A., Mol, Ben W J, and Hoek, Annemieke

Published
2016

11. The LIFESTYLE study: costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial

Author

Mutsaerts, Meike AQ, primary, Groen, Henk, additional, ter Bogt, Nancy CW, additional, Bolster, Johanna HT, additional, Land, Jolande A, additional, Bemelmans, Wanda JE, additional, Kuchenbecker, Walter KH, additional, Hompes, Peter GA, additional, Macklon, Nick S, additional, Stolk, Ronald P, additional, van der Veen, Fulco, additional, Maas, Jacques WM, additional, Klijn, Nicole F, additional, Kaaijk, Eugenie M, additional, Oosterhuis, Gerrit JE, additional, Bouckaert, Peter XJM, additional, Schierbeek, Jaap M, additional, van Kasteren, Yvonne M, additional, Nap, Annemiek W, additional, Broekmans, Frank J, additional, Brinkhuis, Egbert A, additional, Koks, Carolien AM, additional, Burggraaff, Jan M, additional, Blankhart, Adrienne S, additional, Perquin, Denise AM, additional, Gerards, Marie H, additional, Mulder, Robert JAB, additional, Gondrie, Ed TCM, additional, Mol, Ben WJ, additional, and Hoek, Annemieke, additional

Published
2010
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14. Sole proprietor; growing things is my business, but growing my business is not necessarily my thing

Author

Mulder, Robert

Subjects
Corporate growth -- Analysis, Small business -- Management -- Analysis, Businessmen -- Beliefs, opinions and attitudes, Business, general, Business, Company business management, Small business, Industry growth, SOHO, Management, Beliefs, opinions and attitudes, Analysis
Abstract

SOLE PROPRIETOR I OWN A SMALL LANDSCAPING BUSINESS that operates out of my house in Raleigh, N.C. The business, Amsterdam Landscaping, grosses less than $50,000 annually. I have three part-time [...]

Published
1986

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