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52. Orbitofrontal gray matter relates to early morning awakening: a neural correlate of insomnia complaints?

Author

Stoffers, D., Moens, S., Benjamins, J., van Tol, M.J., Penninx, B.W.J.H., Veltman, D.J., van der Wee, N.J.A., van Someren, E.J.W., Stoffers, D., Moens, S., Benjamins, J., van Tol, M.J., Penninx, B.W.J.H., Veltman, D.J., van der Wee, N.J.A., and van Someren, E.J.W.

Abstract

Sleep complaints increase profoundly with age; prevalence estimates of insomnia in the elderly reach up to 37%.The three major types of nocturnal complaints are difficulties initiating (DIS) and maintaining (DMS) sleep and early morning awakening (EMA), of which the latter appears most characteristic for aging. The neural correlates associated with these complaints have hardly been investigated, hampering the development of rational treatment and prevention. A recent study on structural brain correlates of insomnia showed that overall severity, but not duration, of insomnia complaints is associated with lower gray matter (GM) density in part of the left orbitofrontal cortex (OFC). Following up on this, we investigated, in an independent sample of people not diagnosed with insomnia, whether individual differences inGMdensity are associated with differences in DIS, DMS, and EMA. Sixty five healthy participants (mean ageD41 years, range 18-56) filled out questionnaires and underwent structural magnetic resonance imaging. Three compound Z-scores were computed for questionnaire items relating to DIS, DMS, and EMA.Whole-brain voxel-based morphometrywas used to investigate their association withGMdensity. Results showthat participants with lowerGMdensity in a region where the left inferior OFC borders the insula report more EMA, but not DIS or DMS.This is the first study to investigate structural brain correlates of specific sleep characteristics that can translate into complaints in insomniacs. The selective association of EMA with orbitofrontal GM density makes our findings particularly relevant to elderly people, where EMA represents the most characteristic complaint. It is hypothesized that low GM density in aforementioned orbitofrontal area affects its role in sensing comfort. An intact ability to evaluate comfort may be crucial to maintain sleep, especially at the end of the night when sleep is vulnerable because homeostatic sleep propensity has dissipated. © 2012 St

Published
2012
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53. Static and dynamic properties of proteins adsorbed at liquid interfaces

Author

Benjamins, J., Agricultural University, J. Lyklema, and E.H. Lucassen-Reynders

Subjects
colloidal properties, emulsies, adsorptie, schuim, adsorption, Laboratorium voor Fysische chemie en Kolloïdkunde, foams, colloïdale eigenschappen, emulsions, eiwitten, Physical Chemistry and Colloid Science, proteins
Abstract

The aim of the investigation described in this thesis was to increase the level of understanding of the role that proteins play in the preparation and subsequent stabilisation of foams and emulsions. One aspect of this role is facilitation of break-up, due to surface tension lowering. A second aspect is the formation of a viscoelastic interfacial layer, which affects both the short-term and long-term stability of the dispersion. Therefore, a systematic study of the changes in static and dynamic interfacial properties induced by proteins was carried out.For part of this study, dealing with the interfacial rheology, several experimental techniques were used. These techniques were either properly modified existing techniques (Chapter 3, modified longitudinal wave set-up) or newly developed (Chapter 4, Dynamic Drop Tensiometer; Chapter 5, Concentric Ring Surface Shear Rheometer) to meet the requirements for measuring the rheology of adsorbed protein layers at liquid/liquid interfaces. These requirements are (i) isotropic deformation, without leakage of the interfacial layer, for the dilational modulus measurements at air/water and oil/water interfaces and (ii) shear modulus measurements at small oscillatory deformation.The proteins chosen for this study wereβ-casein,β-lactoglobulin (BLG), bovine serum albumin (BSA), ovalbumin and lysozyme. This set of proteins was chosen, because they differ considerably in relevant aspects, such as molecular weight, molecular structure and iso-electric point.In Chapter 1 the scope and context of this study are given including a brief introduction into (i) the molecular properties of these proteins, that are relevant to the adsorption, (ii) protein adsorption and interfacial rheology, and (iii) the relation between interfacial properties and the properties of emulsions and foams.Chapter 2 deals with the adsorption of proteins at the air/water interface. The adsorption was determined by ellipsometry, a method by which not only the adsorbed amount but also the layer thickness and protein concentration in the adsorbed layer could be determined. The ellipsometric studies were combined with surface tension measurements at the same surface.All proteins examined show high affinity adsorption, i.e. strong adsorption at low concentration in solution. The initial rate of adsorption of all proteins is well described by a simple diffusion equation. For all proteins examined, the value of the surface pressure (Π) are protein-specific, but otherwise unique, time-independent functions of the adsorption (Γ). Time independence of theΠ(Γ) curve was concluded from the finding thatΠandΓpairs measured at different bulk concentrations and at different stages of adsorption, all collapse into one single curve. In other words, each protein has a unique surface equation of state indicated by its measuredΠ(Γ) curve. This curve reflects the relative rigidity of the protein molecule. For flexible molecules likeβ-casein and PVA ,Γ min (=ΓwhereΠstarts to deviate measurably from zero) is low and from this point onward the surface pressure increases gradually with increasingΓ. For rigid globular proteins (BSA, ovalbumin and lysozyme)Γ min is higher and with further increase of the surface concentration the surface pressure increases steeply. At high protein concentration and long adsorption times, for most proteins multilayer adsorption takes place.For ovalbumin, in the pH range 4-8 the effect of pH on theΠ-Γcurve is small, which indicates that electrostatic intermolecular forces do not contribute much to the surface pressure.In Chapter 3 a longitudinal wave technique, modified to ensure isotropic surface deformation, was used to determine the dilational modulus,ε, of adsorbed protein layers, at the air/water interface. This modification fully eliminated the complicating shear effects that became apparent in dilational modulus measurements with adsorbed layers of proteins in a conventional set-up.For all proteins examined at frequencies in the range from 0.01 to 1 rad/s, the initial part of theε(Π) plot is a straight line through the origin. The slope of this initial part ranges between +4 and +12 . No clear relationship between the slope and the rigidity of the protein molecule was found. However, the extent of this linear range is smaller for the flexible molecules (β-casein and PVA). From the fact that this slope significantly exceeds the ideal value of +1, it must be concluded that the behaviour of the adsorbed layer is far from ideal. In the linear range, the measured moduli coincide with the limiting moduli,ε 0 , calculated from theΠ(Γ) curve. This indicates that the surface pressure adjusts "instantaneously" to the changing adsorption during a compression-expansion cycle in time-scales ranging from 1 to 100 s. This also means that the modulus is purely elastic, i.e. the effect of relaxation processes is negligible. In this elastic range, differences between individual proteins are related to different degrees of non-ideality, reflected in the surface equation of state.At higher surface concentrations a relaxation mechanism becomes operative, which is most probably not caused by diffusional exchange between surface and solution. This conclusion is based on calculations of the diffusional transport rate and the theoretical frequency spectrum of the modulus. Relaxation due to conformational changes is plausible. In the visco-elastic regionε≥ε 0 for all proteins examined. This is an extra argument against diffusional exchange.The modulus increases in the order: PVA 1g/l), during the first minutes after adsorption a situation exists that differs from the equilibriumΠ(Γ) curve. At low interfacial pressures, during a modulus measurement, the adaptation of the conformation is faster (< 1 s.). Non-ideality of the adsorbed layer increases in the sequence TAG-oil < tetradecane < air, which is probably related to a decrease of solution quality for the more hydrophobic amino acids, which decreases in the same sequence. At each of the different interfaces non-ideality increases with increasing rigidity of the protein molecule (β-casein

Published
2000

55. The sleep registry. An international online survey and cognitive test assessment tool and database for multivariate sleep and insomnia phenotyping

Author

Benjamins, J., primary, Migliorati, F., additional, Dekker, K., additional, Wassing, R., additional, Moens, S., additional, Van Someren, E., additional, Hartescu, L., additional, Itzhacki, J., additional, Pinto, T., additional, Tesler, N., additional, Perrier, J., additional, Garbazza, C., additional, and Jarkiewicz, M., additional

Published
2013
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56. Ellipsometric characterization of ethylene oxide-butylene oxide diblock copolymer adsorption at the air-water interface

Author

Rippner Blomqvist, Brita, Benjamins, J. W., Nylander, T., Arnebrant, Thomas, Rippner Blomqvist, Brita, Benjamins, J. W., Nylander, T., and Arnebrant, Thomas

Abstract

Ellipsometry was used to determine the adsorbed layer thickness (d) and the surface excess (adsorbed amount, Gamma) of a nonionic diblock copolymer, E106B16, of poly(ethylene oxide) (E) and poly(butylene oxide) (13) at the air-water interface. The results were obtained (i) by the conventional ellipsometric evaluation procedure using the change of both ellipsometric angles, T and A and (ii) by using the change of A only and assuming values of the layer thickness. It was demonstrated that the calculated surface excesses from the different methods were in close agreement, independent of the evaluation procedure, with a plateau adsorption of about 2.5 mg/m(2) (400 A(2)/molecule). Furthermore, the amount of E106B16 adsorbed at the air-water interface was found to be almost identical to that adsorbed from aqueous solution onto a hydrophobic solid surface. In addition, the possibility to use combined measurements with H2O or D2O as substrates to calculate values of d and F was investigated and discussed. We also briefly discuss within which limits the Gibbs equation can be used to determine the surface excess of polydisperse block copolymers., QC 20101011

Published
2005
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78. Formation of a Liquid Crystalline Phase from Phosphatidylcholine at the Oil−Aqueous Interface

Author

Benjamins, J.-W., Thuresson, K., and Nylander, T.

Abstract

Adsorption of phospholipid (1,2-dioleoyl-sn-glycero-3-phosphatidylcholine) and formation of a surface phase at the oil−water interface has been followed by using ellipsometry. The properties of the interfacial phase were found to depend strongly on whether phospholipid was added to the oil phase or to the aqueous phase as liposomal structures. In the latter case a monolayer formed, while if the phospholipid was supplied from the oil phase a lamellar phase appeared at the interface. The effect on the stabilizing surface phase of a surface-active protein (β-lactoglobulin) was also investigated. The observations are important for understanding stabilizing properties of surface-active compounds commonly used to stabilize emulsions. In addition it has been demonstrated that ellipsometry can be used to study the initial process when a two-phase system consisting of a water and an oil phase is transformed into a three phase system or eventually to a one-phase system.

Published
2005

79. Ellipsometry Studies of Nonionic Surfactant Adsorption at the Oil−Water Interface

Author

Benjamins, J.-W., Thuresson, K., and Nylander, T.

Abstract

In the presented study we have developed and implemented a methodology for ellipsometry measurements at liquid interfaces that makes it possible to determine the amount adsorbed without assumptions of refractive index or thickness of the adsorbed layer. It was demonstrated that this is possible by combined measurements from different aqueous phases, H2O and D2O, which were shown to have sufficiently different refractive indices. The methodology was tested by studying adsorption of two types of nonionic poly(ethylene glycol) alkyl ether surfactants, CnH2n+1(OC2H4)mOH or CnEm at the decane−aqueous interface, where C12E5 was adsorbed from the oil phase and C18E50 from the aqueous phase. The observed plateau values of the adsorbed amounts were 1.38 and 0.93 mg/m2 for C12E5 and C18E50, respectively, which is in agreement with the corresponding values of 1.49 and 1.15 mg/m2 obtained from applying the Gibbs equation to interfacial tension data for the same systems. We will briefly discuss the adsorption behavior in relation to the molecular structure of the surfactant and the phase behavior of the oil−surfactant−aqueous systems in relation to our experimental results.

Published
2005

80. New Experimental Setup To Use Ellipsometry To Study Liquid−Liquid and Liquid−Solid Interfaces

Author

Benjamins, J.-W., Jonsson, B., Thuresson, K., and Nylander, T.

Abstract

Different types of optical light guides were constructed and tested to enable convenient multiple angle of incidence ellipsometry, on solid and liquid interfaces in liquid solutions. Two light guides are needed on an ellipsometer, one to guide the incoming light and one to guide the light that is reflected at the test surface, and therefore one light guide was mounted on the laser arm and one on the detector arm of the ellipsometer. With this arrangement the optical windows automatically adjust to always be perpendicular to the direction of the light independent of the angle of incidence. The purpose with these light guides is to facilitate the passage of light through the air/solution interface. A thorough theoretical and experimental analysis of optical errors introduced by such light guides is presented. This discussion includes the effect of multiple reflections between and within the windows of the light guides. On the basis of this analysis a new ellipsometry setup with light guides, consisting of glass tubes with glued end windows, was developed. This setup makes it possible to perform accurate measurements in almost any type of measuring cell at any angle of incidence.

Published
2002
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81. In vitro acylation of rat brain myelin proteolipid protein.

Author

Townsend, L E, Agrawal, D, Benjamins, J A, and Agrawal, H C

Abstract

The incorporation of fatty acid into myelin proteolipid protein (PLP) was studied by incubating brain slices from 17-day-old rats with [9,10-3H]palmitic acid. Myelin proteins were analyzed by gel electrophoresis. As in vivo (Agrawal, H. C., Randle, C. L., and Agrawal, D. (1982) J. Biol. Chem. 257, 4588-4592) most of the radioactivity co-migrated with PLP, with radioactivity also appearing in the regions of the DM-20 and Wolfgram proteins. Treatment of myelin proteins or purified PLP with 1 M hydroxylamine released most of the radioactivity, indicating that [3H]palmitic acid was covalently bound by ester linkage to the proteins. Cleavage of PLP with methanolic NaOH and examination of the released fatty acids by thin layer chromatography showed radioactivity associated with the methyl esters of palmitate, stearate, and oleate (76, 23, and 1%, respectively). A linear increase in radioactivity from [3H]palmitic acid was observed in PLP in both myelin and myelin-like fractions, while appearance of [14C]glycine-labeled PLP showed a lag of 45-60 minutes. These results indicate that lipid is added to PLP in the myelin and myelin-like membranes, or immediately prior to the appearance of PLP in these fractions. For both precursors, the specific activity of PLP was greater in the myelin-like fraction than in myelin, indicating that the myelin-like fraction may contain a precursor pool of PLP for myelin.

Published
1982
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82. Insomnia: restless REM sleep promotes nocturnal mentation and hyperarousal by interfering with the resolution of emotional distress

Author

Wassing, R., Benjamins, J. S., Dekker, K., Moens, S., Spiegelhalder, K., Bernd Feige, Riemann, D., Sluis, S., Werf, Y. D., Talamini, L. M., Walker, M., Schalkwijk, F., Someren, E. J. W., Human genetics, Amsterdam Neuroscience - Complex Trait Genetics, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, Anatomy and neurosciences, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Compulsivity, Impulsivity & Attention, Psychiatry, and Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep

89. Differential effects of Th1, monocyte/macrophage and Th2 cytokine mixtures on early gene expression for molecules associated with metabolism, signaling and regulation in central nervous system mixed glial cell cultures

Author

Studzinski Diane, Nedelkoska Liljana, Bealmear Beverly, Benjamins Joyce A, Lisak Robert P, Retland Ernest, Yao Bin, and Land Susan

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract Background Cytokines secreted by immune cells and activated glia play central roles in both the pathogenesis of and protection from damage to the central nervous system (CNS) in multiple sclerosis (MS). Methods We have used gene array analysis to identify the initial direct effects of cytokines on CNS glia by comparing changes in early gene expression in CNS glial cultures treated for 6 hours with cytokines typical of those secreted by Th1 and Th2 lymphocytes and monocyte/macrophages (M/M). Results In two previous papers, we summarized effects of these cytokines on immune-related molecules, and on neural and glial related proteins, including neurotrophins, growth factors and structural proteins. In this paper, we present the effects of the cytokines on molecules involved in metabolism, signaling and regulatory mechanisms in CNS glia. Many of the changes in gene expression were similar to those seen in ischemic preconditioning and in early inflammatory lesions in experimental autoimmune encephalomyelitis (EAE), related to ion homeostasis, mitochondrial function, neurotransmission, vitamin D metabolism and a variety of transcription factors and signaling pathways. Among the most prominent changes, all three cytokine mixtures markedly downregulated the dopamine D3 receptor, while Th1 and Th2 cytokines downregulated neuropeptide Y receptor 5. An unexpected finding was the large number of changes related to lipid metabolism, including several suggesting a switch from diacylglycerol to phosphatidyl inositol mediated signaling pathways. Using QRT-PCR we validated the results for regulation of genes for iNOS, arginase and P glycoprotein/multi-drug resistance protein 1 (MDR1) seen at 6 hours with microarray. Conclusion Each of the three cytokine mixtures differentially regulated gene expression related to metabolism and signaling that may play roles in the pathogenesis of MS, most notably with regard to mitochondrial function and neurotransmitter signaling in glia.

Published
2009
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90. Differential effects of Th1, monocyte/macrophage and Th2 cytokine mixtures on early gene expression for glial and neural-related molecules in central nervous system mixed glial cell cultures: neurotrophins, growth factors and structural proteins

Author

Nedelkoska Liljana, Bealmear Beverly, Benjamins Joyce A, Lisak Robert P, Yao Bin, Land Susan, and Studzinski Diane

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract Background In multiple sclerosis, inflammatory cells are found in both active and chronic lesions, and it is increasingly clear that cytokines are involved directly and indirectly in both formation and inhibition of lesions. We propose that cytokine mixtures typical of Th1 or Th2 lymphocytes, or monocyte/macrophages each induce unique molecular changes in glial cells. Methods To examine changes in gene expression that might occur in glial cells exposed to the secreted products of immune cells, we have used gene array analysis to assess the early effects of different cytokine mixtures on mixed CNS glia in culture. We compared the effects of cytokines typical of Th1 and Th2 lymphocytes and monocyte/macrophages (M/M) on CNS glia after 6 hours of treatment. Results In this paper we focus on changes with potential relevance for neuroprotection and axon/glial interactions. Each mixture of cytokines induced a unique pattern of changes in genes for neurotrophins, growth and maturation factors and related receptors; most notably an alternatively spliced form of trkC was markedly downregulated by Th1 and M/M cytokines, while Th2 cytokines upregulated BDNF. Genes for molecules of potential importance in axon/glial interactions, including cell adhesion molecules, connexins, and some molecules traditionally associated with neurons showed significant changes, while no genes for myelin-associated genes were regulated at this early time point. Unexpectedly, changes occurred in several genes for proteins initially associated with retina, cancer or bone development, and not previously reported in glial cells. Conclusion Each of the three cytokine mixtures induced specific changes in gene expression that could be altered by pharmacologic strategies to promote protection of the central nervous system.

Published
2007
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91. PROTEOLIPID PROTEIN CO-LOCALIZES WITH SITES OF WGA-BINDING AND ENDOCYTOSIS ON MEMBRANE SHEETS OF MATURE OLIGODENDROCYTES.

Author

Nedelkoska, L., Benjamins, J. A., and Elferirik, L.

Subjects
*MEDICAL research, *PROTEINS, *ENDOCYTOSIS, *ABSORPTION (Physiology)
Abstract

The article presents an abstract related to a medical research which says that proteolipid protein co-localizes with sites of WGA-binding and endocytosis on membrane sheets of mature oligodendrocytes. For normal membrane assembly and recycling, endocytosis is critical. The research has also observed endocytosis of rhodamine-labeled transferrin.

Published
1999

93. The power of genetic diversity in genome-wide association studies of lipids

Author

Graham, Sarah E, Clarke, Shoa L, Wu, Kuan-Han H, Kanoni, Stavroula, Zajac, Greg JM, Ramdas, Shweta, Surakka, Ida, Ntalla, Ioanna, Vedantam, Sailaja, Winkler, Thomas W, Locke, Adam E, Marouli, Eirini, Hwang, Mi Yeong, Han, Sohee, Narita, Akira, Choudhury, Ananyo, Bentley, Amy R, Ekoru, Kenneth, Verma, Anurag, Trivedi, Bhavi, Martin, Hilary C, Hunt, Karen A, Hui, Qin, Klarin, Derek, Zhu, Xiang, Thorleifsson, Gudmar, Helgadottir, Anna, Gudbjartsson, Daniel F, Holm, Hilma, Olafsson, Isleifur, Akiyama, Masato, Sakaue, Saori, Terao, Chikashi, Kanai, Masahiro, Zhou, Wei, Brumpton, Ben M, Rasheed, Humaira, Ruotsalainen, Sanni E, Havulinna, Aki S, Veturi, Yogasudha, Feng, QiPing, Rosenthal, Elisabeth A, Lingren, Todd, Pacheco, Jennifer Allen, Pendergrass, Sarah A, Haessler, Jeffrey, Giulianini, Franco, Bradford, Yuki, Miller, Jason E, Campbell, Archie, Lin, Kuang, Millwood, Iona Y, Hindy, George, Rasheed, Asif, Faul, Jessica D, Zhao, Wei, Weir, David R, Turman, Constance, Huang, Hongyan, Graff, Mariaelisa, Mahajan, Anubha, Brown, Michael R, Zhang, Weihua, Yu, Ketian, Schmidt, Ellen M, Pandit, Anita, Gustafsson, Stefan, Yin, Xianyong, Luan, Jian’an, Zhao, Jing-Hua, Matsuda, Fumihiko, Jang, Hye-Mi, Yoon, Kyungheon, Medina-Gomez, Carolina, Pitsillides, Achilleas, Hottenga, Jouke Jan, Willemsen, Gonneke, Wood, Andrew R, Ji, Yingji, Gao, Zishan, Haworth, Simon, Mitchell, Ruth E, Chai, Jin Fang, Aadahl, Mette, Yao, Jie, Manichaikul, Ani, Warren, Helen R, Ramirez, Julia, Bork-Jensen, Jette, Kårhus, Line L, Goel, Anuj, Sabater-Lleal, Maria, Noordam, Raymond, Sidore, Carlo, Fiorillo, Edoardo, McDaid, Aaron F, Marques-Vidal, Pedro, Wielscher, Matthias, Trompet, Stella, Sattar, Naveed, Møllehave, Line T, Thuesen, Betina H, Munz, Matthias, Zeng, Lingyao, Huang, Jianfeng, Yang, Bin, Poveda, Alaitz, Kurbasic, Azra, Lamina, Claudia, Forer, Lukas, Scholz, Markus, Galesloot, Tessel E., Bradfield, Jonathan P., Daw, E Warwick, Zmuda, Joseph M, Mitchell, Jonathan S, Fuchsberger, Christian, Christensen, Henry, Brody, Jennifer A, Feitosa, Mary F, Wojczynski, Mary K, Preuss, Michael, Mangino, Massimo, Christofidou, Paraskevi, Verweij, Niek, Benjamins, Jan W, Engmann, Jorgen, Kember, Rachel L, Slieker, Roderick C, Lo, Ken Sin, Zilhao, Nuno R, Le, Phuong, Kleber, Marcus E, Delgado, Graciela E, Huo, Shaofeng, Ikeda, Daisuke D, Iha, Hiroyuki, Yang, Jian, Liu, Jun, Leonard, Hampton L, Marten, Jonathan, Schmidt, Börge, Arendt, Marina, Smyth, Laura J, Cañadas-Garre, Marisa, Wang, Chaolong, Nakatochi, Masahiro, Wong, Andrew, Hutri-Kähönen, Nina, Sim, Xueling, Xia, Rui, Huerta-Chagoya, Alicia, Fernandez-Lopez, Juan Carlos, Lyssenko, Valeriya, Ahmed, Meraj, Jackson, Anne U, Irvin, Marguerite R, Oldmeadow, Christopher, Kim, Han-Na, Ryu, Seungho, Timmers, Paul RHJ, Arbeeva, Liubov, Dorajoo, Rajkumar, Lange, Leslie A, Chai, Xiaoran, Prasad, Gauri, Lorés-Motta, Laura, Pauper, Marc, Long, Jirong, Li, Xiaohui, Theusch, Elizabeth, Takeuchi, Fumihiko, Spracklen, Cassandra N, Loukola, Anu, Bollepalli, Sailalitha, Warner, Sophie C, Wang, Ya Xing, Wei, Wen B., Nutile, Teresa, Ruggiero, Daniela, Sung, Yun Ju, Hung, Yi-Jen, Chen, Shufeng, Liu, Fangchao, Yang, Jingyun, Kentistou, Katherine A, Gorski, Mathias, Brumat, Marco, Meidtner, Karina, Bielak, Lawrence F, Smith, Jennifer A, Hebbar, Prashantha, Farmaki, Aliki-Eleni, Hofer, Edith, Lin, Maoxuan, Xue, Chao, Zhang, Jifeng, Concas, Maria Pina, Vaccargiu, Simona, van der Most, Peter J, Pitkänen, Niina, Cade, Brian E, Lee, Jiwon, van der Laan, Sander W., Chitrala, Kumaraswamy Naidu, Weiss, Stefan, Zimmermann, Martina E, Lee, Jong Young, Choi, Hyeok Sun, Nethander, Maria, Freitag-Wolf, Sandra, Southam, Lorraine, Rayner, Nigel W, Wang, Carol A, Lin, Shih-Yi, Wang, Jun-Sing, Couture, Christian, Lyytikäinen, Leo-Pekka, Nikus, Kjell, Cuellar-Partida, Gabriel, Vestergaard, Henrik, Hildalgo, Bertha, Giannakopoulou, Olga, Cai, Qiuyin, Obura, Morgan O, van Setten, Jessica, Li, Xiaoyin, Schwander, Karen, Terzikhan, Natalie, Shin, Jae Hun, Jackson, Rebecca D, Reiner, Alexander P, Martin, Lisa Warsinger, Chen, Zhengming, Li, Liming, Highland, Heather M, Young, Kristin L, Kawaguchi, Takahisa, Thiery, Joachim, Bis, Joshua C, Nadkarni, Girish N., Launer, Lenore J, Li, Huaixing, Nalls, Mike A, Raitakari, Olli T, Ichihara, Sahoko, Wild, Sarah H, Nelson, Christopher P, Campbell, Harry, Jäger, Susanne, Nabika, Toru, Al-Mulla, Fahd, Niinikoski, Harri, Braund, Peter S, Kolcic, Ivana, Kovacs, Peter, Giardoglou, Tota, Katsuya, Tomohiro, Bhatti, Konain Fatima, de Kleijn, Dominique, de Borst, Gert J., Kim, Eung Kweon, Adams, Hieab H.H., Ikram, M. Arfan, Zhu, Xiaofeng, Asselbergs, Folkert W, Kraaijeveld, Adriaan O, Beulens, Joline WJ, Shu, Xiao-Ou, Rallidis, Loukianos S, Pedersen, Oluf, Hansen, Torben, Mitchell, Paul, Hewitt, Alex W, Kähönen, Mika, Pérusse, Louis, Bouchard, Claude, Tönjes, Anke, Chen, Yii-Der Ida, Pennell, Craig E, Mori, Trevor A, Lieb, Wolfgang, Franke, Andre, Ohlsson, Claes, Mellström, Dan, Cho, Yoon Shin, Lee, Hyejin, Yuan, Jian-Min, Koh, Woon-Puay, Rhee, Sang Youl, Woo, Jeong-Taek, Heid, Iris M, Stark, Klaus J, Völzke, Henry, Homuth, Georg, Evans, Michele K, Zonderman, Alan B, Polasek, Ozren, Pasterkamp, Gerard, Hoefer, Imo E, Redline, Susan, Pahkala, Katja, Oldehinkel, Albertine J, Snieder, Harold, Biino, Ginevra, Schmidt, Reinhold, Schmidt, Helena, Chen, Y Eugene, Bandinelli, Stefania, Dedoussis, George, Thanaraj, Thangavel Alphonse, Kardia, Sharon LR, Kato, Norihiro, Schulze, Matthias B, Girotto, Giorgia, Jung, Bettina, Böger, Carsten A, Joshi, Peter K, Bennett, David A, De Jager, Philip L, Lu, Xiangfeng, Mamakou, Vasiliki, Brown, Morris, Caulfield, Mark J, Munroe, Patricia B, Guo, Xiuqing, Ciullo, Marina, Jonas, Jost B., Samani, Nilesh J, Chasman, Daniel I., Kaprio, Jaakko, Pajukanta, Päivi, Tusié-Luna, Teresa, Aguilar-Salinas, Carlos A, Adair, Linda S, Bechayda, Sonny Augustin, de Silva, H. Janaka, Wickremasinghe, Ananda R, Krauss, Ronald M, Wu, Jer-Yuarn, Zheng, Wei, den Hollander, Anneke I, Bharadwaj, Dwaipayan, Correa, Adolfo, Wilson, James G, Lind, Lars, Heng, Chew-Kiat, Nelson, Amanda E, Golightly, Yvonne M, Wilson, James F, Penninx, Brenda, Kim, Hyung-Lae, Attia, John, Scott, Rodney J, Rao, D C, Arnett, Donna K, Walker, Mark, Koistinen, Heikki A, Chandak, Giriraj R, Yajnik, Chittaranjan S, Mercader, Josep M, Tusie-Luna, Teresa, Aguilar-Salinas, Carlos, Villalpando, Clicerio Gonzalez, Orozco, Lorena, Fornage, Myriam, Tai, E Shyong, van Dam, Rob M, Lehtimäki, Terho, Chaturvedi, Nish, Yokota, Mitsuhiro, Liu, Jianjun, Reilly, Dermot F, McKnight, Amy Jayne, Kee, Frank, Jöckel, Karl-Heinz, McCarthy, Mark I, Palmer, Colin NA, Vitart, Veronique, Hayward, Caroline, Simonsick, Eleanor, van Duijn, Cornelia M, Lu, Fan, Qu, Jia, Hishigaki, Haretsugu, Lin, Xu, März, Winfried, Parra, Esteban J, Cruz, Miguel, Gudnason, Vilmundur, Tardif, Jean-Claude, Lettre, Guillaume, Hart, Leen M t, Elders, Petra JM, Rader, Daniel J, Damrauer, Scott M, Kumari, Meena, Kivimaki, Mika, van der Harst, Pim, Spector, Tim D, Loos, Ruth J.F., Province, Michael A, Psaty, Bruce M, Brandslund, Ivan, Pramstaller, Peter P, Christensen, Kaare, Ripatti, Samuli, Widén, Elisabeth, Hakonarson, Hakon, Grant, Struan F.A., Kiemeney, Lambertus ALM, de Graaf, Jacqueline, Loeffler, Markus, Kronenberg, Florian, Gu, Dongfeng, Erdmann, Jeanette, Schunkert, Heribert, Franks, Paul W, Linneberg, Allan, Jukema, J. Wouter, Khera, Amit V, Männikkö, Minna, Jarvelin, Marjo-Riitta, Kutalik, Zoltan, Cucca, Francesco, Mook-Kanamori, Dennis O, van Dijk, Ko Willems, Watkins, Hugh, Strachan, David P, Grarup, Niels, Sever, Peter, Poulter, Neil, Rotter, Jerome I, Dantoft, Thomas M, Karpe, Fredrik, Neville, Matt J, Timpson, Nicholas J, Cheng, Ching-Yu, Wong, Tien-Yin, Khor, Chiea Chuen, Sabanayagam, Charumathi, Peters, Annette, Gieger, Christian, Hattersley, Andrew T, Pedersen, Nancy L, Magnusson, Patrik KE, Boomsma, Dorret I, de Geus, Eco JC, Cupples, L Adrienne, van Meurs, Joyce B.J., Ghanbari, Mohsen, Gordon-Larsen, Penny, Huang, Wei, Kim, Young Jin, Tabara, Yasuharu, Wareham, Nicholas J, Langenberg, Claudia, Zeggini, Eleftheria, Kuusisto, Johanna, Laakso, Markku, Ingelsson, Erik, Abecasis, Goncalo, Chambers, John C, Kooner, Jaspal S, de Vries, Paul S, Morrison, Alanna C, North, Kari E., Daviglus, Martha, Kraft, Peter, Martin, Nicholas G, Whitfield, John B, Abbas, Shahid, Saleheen, Danish, Walters, Robin G, Holmes, Michael V, Black, Corri, Smith, Blair H, Justice, Anne E, Baras, Aris, Buring, Julie E, Ridker, Paul M, Chasman, Daniel I, Kooperberg, Charles, Wei, Wei-Qi, Jarvik, Gail P, Namjou, Bahram, Hayes, M. Geoffrey, Ritchie, Marylyn D, Jousilahti, Pekka, Salomaa, Veikko, Hveem, Kristian, Åsvold, Bjørn Olav, Kubo, Michiaki, Kamatani, Yoichiro, Okada, Yukinori, Murakami, Yoshinori, Thorsteinsdottir, Unnur, Stefansson, Kari, Ho, Yuk-Lam, Lynch, Julie A, Rader, Daniel, Tsao, Phil S, Chang, Kyong-Mi, Cho, Kelly, O’Donnell, Christopher J, Gaziano, John M, Wilson, Peter, Rotimi, Charles N, Hazelhurst, Scott, Ramsay, Michèle, Trembath, Richard C, van Heel, David A, Tamiya, Gen, Yamamoto, Masayuki, Kim, Bong-Jo, Mohlke, Karen L, Frayling, Timothy M, Hirschhorn, Joel N, Kathiresan, Sekar, Boehnke, Michael, Natarajan, Pradeep, Peloso, Gina M, Brown, Christopher D, Morris, Andrew P, Assimes, Themistocles L, Deloukas, Panos, Sun, Yan V, Willer, Cristen J, VA Million Veteran Program, Global Lipids Genetics Consortium, Internal Medicine, Epidemiology, Radiology & Nuclear Medicine, Graham, S. E., Clarke, S. L., Wu, K. -H. H., Kanoni, S., Zajac, G. J. M., Ramdas, S., Surakka, I., Ntalla, I., Vedantam, S., Winkler, T. W., Locke, A. E., Marouli, E., Hwang, M. Y., Han, S., Narita, A., Choudhury, A., Bentley, A. R., Ekoru, K., Verma, A., Trivedi, B., Martin, H. C., Hunt, K. A., Hui, Q., Klarin, D., Zhu, X., Thorleifsson, G., Helgadottir, A., Gudbjartsson, D. F., Holm, H., Olafsson, I., Akiyama, M., Sakaue, S., Terao, C., Kanai, M., Zhou, W., Brumpton, B. M., Rasheed, H., Ruotsalainen, S. E., Havulinna, A. S., Veturi, Y., Feng, Q. P., Rosenthal, E. A., Lingren, T., Pacheco, J. A., Pendergrass, S. A., Haessler, J., Giulianini, F., Bradford, Y., Miller, J. E., Campbell, A., Lin, K., Millwood, I. Y., Hindy, G., Rasheed, A., Faul, J. D., Zhao, W., Weir, D. R., Turman, C., Huang, H., Graff, M., Mahajan, A., Brown, M. R., Zhang, W., Yu, K., Schmidt, E. M., Pandit, A., Gustafsson, S., Yin, X., Luan, J., Zhao, J. -H., Matsuda, F., Jang, H. -M., Yoon, K., Medina-Gomez, C., Pitsillides, A., Hottenga, J. J., Willemsen, G., Wood, A. R., Ji, Y., Gao, Z., Haworth, S., Mitchell, R. E., Chai, J. F., Aadahl, M., Yao, J., Manichaikul, A., Warren, H. R., Ramirez, J., Bork-Jensen, J., Karhus, L. L., Goel, A., Sabater-Lleal, M., Noordam, R., Sidore, C., Fiorillo, E., Mcdaid, A. F., Marques-Vidal, P., Wielscher, M., Trompet, S., Sattar, N., Mollehave, L. T., Thuesen, B. H., Munz, M., Zeng, L., Huang, J., Yang, B., Poveda, A., Kurbasic, A., Lamina, C., Forer, L., Scholz, M., Galesloot, T. E., Bradfield, J. P., Daw, E. W., Zmuda, J. M., Mitchell, J. S., Fuchsberger, C., Christensen, H., Brody, J. A., Feitosa, M. F., Wojczynski, M. K., Preuss, M., Mangino, M., Christofidou, P., Verweij, N., Benjamins, J. W., Engmann, J., Kember, R. L., Slieker, R. C., Lo, K. S., Zilhao, N. R., Le, P., Kleber, M. E., Delgado, G. E., Huo, S., Ikeda, D. D., Iha, H., Yang, J., Liu, J., Leonard, H. L., Marten, J., Schmidt, B., Arendt, M., Smyth, L. J., Canadas-Garre, M., Wang, C., Nakatochi, M., Wong, A., Hutri-Kahonen, N., Sim, X., Xia, R., Huerta-Chagoya, A., Fernandez-Lopez, J. C., Lyssenko, V., Ahmed, M., Jackson, A. U., Irvin, M. R., Oldmeadow, C., Kim, H. -N., Ryu, S., Timmers, P. R. H. J., Arbeeva, L., Dorajoo, R., Lange, L. A., Chai, X., Prasad, G., Lores-Motta, L., Pauper, M., Long, J., Li, X., Theusch, E., Takeuchi, F., Spracklen, C. N., Loukola, A., Bollepalli, S., Warner, S. C., Wang, Y. X., Wei, W. B., Nutile, T., Ruggiero, D., Sung, Y. J., Hung, Y. -J., Chen, S., Liu, F., Kentistou, K. A., Gorski, M., Brumat, M., Meidtner, K., Bielak, L. F., Smith, J. A., Hebbar, P., Farmaki, A. -E., Hofer, E., Lin, M., Xue, C., Zhang, J., Concas, M. P., Vaccargiu, S., van der Most, P. J., Pitkanen, N., Cade, B. E., Lee, J., van der Laan, S. W., Chitrala, K. N., Weiss, S., Zimmermann, M. E., Lee, J. Y., Choi, H. S., Nethander, M., Freitag-Wolf, S., Southam, L., Rayner, N. W., Wang, C. A., Lin, S. -Y., Wang, J. -S., Couture, C., Lyytikainen, L. -P., Nikus, K., Cuellar-Partida, G., Vestergaard, H., Hildalgo, B., Giannakopoulou, O., Cai, Q., Obura, M. O., van Setten, J., Schwander, K., Terzikhan, N., Shin, J. H., Jackson, R. D., Reiner, A. P., Martin, L. W., Chen, Z., Li, L., Highland, H. M., Young, K. L., Kawaguchi, T., Thiery, J., Bis, J. C., Nadkarni, G. N., Launer, L. J., Li, H., Nalls, M. A., Raitakari, O. T., Ichihara, S., Wild, S. H., Nelson, C. P., Campbell, H., Jager, S., Nabika, T., Al-Mulla, F., Niinikoski, H., Braund, P. S., Kolcic, I., Kovacs, P., Giardoglou, T., Katsuya, T., Bhatti, K. F., de Kleijn, D., de Borst, G. J., Kim, E. K., Adams, H. H. H., Ikram, M. A., Asselbergs, F. W., Kraaijeveld, A. O., Beulens, J. W. J., Shu, X. -O., Rallidis, L. S., Pedersen, O., Hansen, T., Mitchell, P., Hewitt, A. W., Kahonen, M., Perusse, L., Bouchard, C., Tonjes, A., Chen, Y. -D. I., Pennell, C. E., Mori, T. A., Lieb, W., Franke, A., Ohlsson, C., Mellstrom, D., Cho, Y. S., Lee, H., Yuan, J. -M., Koh, W. -P., Rhee, S. Y., Woo, J. -T., Heid, I. M., Stark, K. J., Volzke, H., Homuth, G., Evans, M. K., Zonderman, A. B., Polasek, O., Pasterkamp, G., Hoefer, I. E., Redline, S., Pahkala, K., Oldehinkel, A. J., Snieder, H., Biino, G., Schmidt, R., Schmidt, H., Chen, Y. E., Bandinelli, S., Dedoussis, G., Thanaraj, T. A., Kardia, S. L. R., Kato, N., Schulze, M. B., Girotto, G., Jung, B., Boger, C. A., Joshi, P. K., Bennett, D. A., De Jager, P. L., Lu, X., Mamakou, V., Brown, M., Caulfield, M. J., Munroe, P. B., Guo, X., Ciullo, M., Jonas, J. B., Samani, N. J., Kaprio, J., Pajukanta, P., Adair, L. S., Bechayda, S. A., de Silva, H. J., Wickremasinghe, A. R., Krauss, R. M., Wu, J. -Y., Zheng, W., den Hollander, A. I., Bharadwaj, D., Correa, A., Wilson, J. G., Lind, L., Heng, C. -K., Nelson, A. E., Golightly, Y. M., Wilson, J. F., Penninx, B., Kim, H. -L., Attia, J., Scott, R. J., Rao, D. C., Arnett, D. K., Walker, M., Koistinen, H. A., Chandak, G. R., Yajnik, C. S., Mercader, J. M., Tusie-Luna, T., Aguilar-Salinas, C. A., Villalpando, C. G., Orozco, L., Fornage, M., Tai, E. S., van Dam, R. M., Lehtimaki, T., Chaturvedi, N., Yokota, M., Reilly, D. F., Mcknight, A. J., Kee, F., Jockel, K. -H., Mccarthy, M. I., Palmer, C. N. A., Vitart, V., Hayward, C., Simonsick, E., van Duijn, C. M., Lu, F., Qu, J., Hishigaki, H., Lin, X., Marz, W., Parra, E. J., Cruz, M., Gudnason, V., Tardif, J. -C., Lettre, G., 't Hart, L. M., Elders, P. J. M., Damrauer, S. M., Kumari, M., Kivimaki, M., van der Harst, P., Spector, T. D., Loos, R. J. F., Province, M. A., Psaty, B. M., Brandslund, I., Pramstaller, P. P., Christensen, K., Ripatti, S., Widen, E., Hakonarson, H., Grant, S. F. A., Kiemeney, L. A. L. M., de Graaf, J., Loeffler, M., Kronenberg, F., Gu, D., Erdmann, J., Schunkert, H., Franks, P. W., Linneberg, A., Jukema, J. W., Khera, A. V., Mannikko, M., Jarvelin, M. -R., Kutalik, Z., Cucca, F., Mook-Kanamori, D. O., van Dijk, K. W., Watkins, H., Strachan, D. P., Grarup, N., Sever, P., Poulter, N., Rotter, J. I., Dantoft, T. M., Karpe, F., Neville, M. J., Timpson, N. J., Cheng, C. -Y., Wong, T. -Y., Khor, C. C., Sabanayagam, C., Peters, A., Gieger, C., Hattersley, A. T., Pedersen, N. L., Magnusson, P. K. E., Boomsma, D. I., de Geus, E. J. C., Cupples, L. A., van Meurs, J. B. J., Ghanbari, M., Gordon-Larsen, P., Huang, W., Kim, Y. J., Tabara, Y., Wareham, N. J., Langenberg, C., Zeggini, E., Kuusisto, J., Laakso, M., Ingelsson, E., Abecasis, G., Chambers, J. C., Kooner, J. S., de Vries, P. S., Morrison, A. C., North, K. E., Daviglus, M., Kraft, P., Martin, N. G., Whitfield, J. B., Abbas, S., Saleheen, D., Walters, R. G., Holmes, M. V., Black, C., Smith, B. H., Justice, A. E., Baras, A., Buring, J. E., Ridker, P. M., Chasman, D. I., Kooperberg, C., Wei, W. -Q., Jarvik, G. P., Namjou, B., Hayes, M. G., Ritchie, M. D., Jousilahti, P., Salomaa, V., Hveem, K., Asvold, B. O., Kubo, M., Kamatani, Y., Okada, Y., Murakami, Y., Thorsteinsdottir, U., Stefansson, K., Ho, Y. -L., Lynch, J. A., Rader, D. J., Tsao, P. S., Chang, K. -M., Cho, K., O'Donnell, C. J., Gaziano, J. M., Wilson, P., Rotimi, C. N., Hazelhurst, S., Ramsay, M., Trembath, R. C., van Heel, D. A., Tamiya, G., Yamamoto, M., Kim, B. -J., Mohlke, K. L., Frayling, T. M., Hirschhorn, J. N., Kathiresan, S., Boehnke, M., Natarajan, P., Peloso, G. M., Brown, C. D., Morris, A. P., Assimes, T. L., Deloukas, P., Sun, Y. V., Willer, C. J., Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), Life Course Epidemiology (LCE), Cardiovascular Centre (CVC), Biological Psychology, APH - Health Behaviors & Chronic Diseases, APH - Personalized Medicine, APH - Mental Health, APH - Methodology, AMS - Ageing & Vitality, and AMS - Sports

Subjects
blood lipid level, Multifactorial Inheritance, GWAS, blood lipid levels, cardiovascular disease, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Medizin, LOCI, ANCESTRY, VARIANTS, Polymorphism, Single Nucleotide, Linkage Disequilibrium, Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12], Article, Population Groups, SDG 3 - Good Health and Well-being, Humans, Genetic Predisposition to Disease, METAANALYSIS, POLYMORPHISMS, RISK, Multidisciplinary, Cardiovascular Diseases, Genome-Wide Association Study, Cardiovascular Diseases/genetics, Genetic Predisposition to Disease/genetics, Genome-Wide Association Study/methods, Polymorphism, Single Nucleotide/genetics, CHOLESTEROL, Human Genetics, INDIVIDUALS, Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], DISCOVERY, LOW-FREQUENCY, Delivery of Health Care
Abstract

Increased blood lipid levels are heritable risk factors of cardiovascular disease with varied prevalence worldwide owing to different dietary patterns and medication use 1 . Despite advances in prevention and treatment, in particular through reducing low-density lipoprotein cholesterol levels 2 , heart disease remains the leading cause of death worldwide 3 . Genome-wideassociation studies (GWAS) of blood lipid levels have led to important biological and clinical insights, as well as new drug targets, for cardiovascular disease. However, most previous GWAS 4-23 have been conducted in European ancestry populations and may have missed genetic variants that contribute to lipid-level variation in other ancestry groups. These include differences in allele frequencies, effect sizes and linkage-disequilibrium patterns 24 . Here we conduct a multi-ancestry, genome-wide genetic discovery meta-analysis of lipid levels in approximately 1.65 million individuals, including 350,000 of non-European ancestries. We quantify the gain in studying non-European ancestries and provide evidence to support the expansion of recruitment of additional ancestries, even with relatively small sample sizes. We find that increasing diversity rather than studying additional individuals of European ancestry results in substantial improvements in fine-mapping functional variants and portability of polygenic prediction (evaluated in approximately 295,000 individuals from 7 ancestry groupings). Modest gains in the number of discovered loci and ancestry-specific variants were also achieved. As GWAS expand emphasis beyond the identification of genes and fundamental biology towards the use of genetic variants for preventive and precision medicine 25 , we anticipate that increased diversity of participants will lead to more accurate and equitable 26 application of polygenic scores in clinical practice.

Published
2021
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94. Hope for the best or prepare for the worst? Calm perseverance, not vigilant monitoring, contributes to adolescent life satisfaction.

Author

de Ridder D, Weiss L, Gillebaart M, Benjamins J, and Ybema JF

Abstract

Objective: Which kind of self-regulatory strategies contribute to life satisfaction in adolescence?, Materials and Methods: In the present research, we tested two competing hypotheses arguing that either a strategy of vigilant monitoring of opportunities for working towards goal achievement or a calm perseverance strategy steadily working towards goals in a slower pace would promote life satisfaction in a large and diverse sample of adolescents. We also tested whether the employment of these strategies would hinge on perceptions of goal importance and goal attainability., Results: Employing a longitudinal design, we found support that calm perseverance was the sole significant predictor of life satisfaction regardless of goal perceptions. Vigilant monitoring only contributed indirectly to life satisfaction through its positive effects on calm perseverance. Using a calm perseverance strategy was supported by perceiving one's goals as attainable., Discussion and Conclusion: These findings bear important implications for self-regulation theory that has highlighted goal progress as a prerequisite for well-being.

Published
2024
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95. Enhancing interprofessional teamwork between youth care professionals using an electronic health record; a mixed methods intervention study.

Author

Benjamins J, de Vet E, and Haveman-Nies A

Subjects
Child, Humans, Adolescent, Interprofessional Relations, Delivery of Health Care, Focus Groups, Electronic Health Records, Patient Care Team
Abstract

We aimed to investigate whether using a shared electronic patient record (EPR-Youth) strengthened interprofessional teamwork among professionals in youth care and child healthcare. Using a mixed-methods design, we compared two partly overlapping samples of professionals, who completed questionnaires before the introduction of EPR-Youth ( n  = 117) and 24 months thereafter ( n  = 127). Five components of interprofessional teamwork (interdependence, newly created professional activities, flexibility, collective ownership of goals, and reflection on processes) were assessed for this study. Midway through the study period, focus groups were held with 12 professionals to examine how EPR-Youth contributed to interprofessional teamwork. Professionals reported significantly more flexibility after the introduction of EPR-Youth than before. Professionals scored slightly -but not significantly- more positively on the other components of teamwork. Focus group participants reported that using EPR-Youth strengthened their sense of interdependence and collective ownership of goals, and contributed to newly created professional activities. At baseline, levels of interprofessional teamwork differed between organizations. Focus group participants confirmed these differences and attributed them to differences in facilitation of interprofessional teamwork. Our findings suggest that using EPR-Youth can foster interprofessional teamwork. Organizational differences underline that implementing an EPR alone is inadequate: shared definitions of teamwork and organizational facilities are needed to strengthen interprofessional teamwork.

Published
2024
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96. The Effect of Using a Client-Accessible Health Record on Perceived Quality of Care: Interview Study Among Parents and Adolescents.

Author

Benjamins J, de Vet E, de Mortier CA, and Haveman-Nies A

Abstract

Background: Patient-accessible electronic health records (PAEHRs) are assumed to enhance the quality of care, expressed in terms of safety, effectiveness, timeliness, person centeredness, efficiency, and equity. However, research on the impact of PAEHRs on the perceived quality of care among parents, children, and adolescents is largely lacking. In the Netherlands, a PAEHR (Iuvenelis) was developed for preventive child health care and youth care. Parents and adolescents had access to its full content, could manage appointments, ask questions, and comment on written reports., Objective: This study aims to assess whether and how using this PAEHR contributes to perceived quality of care from a client's perspective., Methods: We chose a qualitative design with a phenomenological approach to explore how parents and adolescents perceived the impact of using a PAEHR on quality of care. In-depth interviews that simultaneously included 1 to 3 people were conducted in 2021. In total, 20 participants were included in the study, representing parents and adolescents, both sexes, different educational levels, different native countries, and all participating municipalities. Within this group, 7 of 13 (54%) parents had not previously been informed about the existence of a client portal. Their expectations of using the client portal, in relation to quality of care, were discussed after a demonstration of the portal., Results: Parents and adolescents perceived that using Iuvenelis contributed to the quality of care because they felt better informed and more involved in the care process than before the introduction of Iuvenelis. Moreover, they experienced more control over their health data, faster and simpler access to their health information, and found it easier to manage appointments or ask questions at their convenience. Parents from a migratory background, among whom 6 of 7 (86%) had not previously been informed about the portal, expected that portal access would enhance their understanding of and control over their care processes. The parents expressed concerns about equity because parents from a migratory background might have less access to the service. Nevertheless, portal usability was regarded as high. Furthermore, both parents and adolescents saw room for improvement in the broader interdisciplinary use of Iuvenelis and the quality of reporting., Conclusions: Using Iuvenelis can contribute to the client-experienced quality of care, more specifically to perceived person centeredness, timeliness, safety, efficiency, and integration of care. However, some quality aspects, such as equity, still need addressing. In general, client information about the portal needs to be improved, specifically focusing on people in vulnerable circumstances, such as those from migratory backgrounds. In addition, to maximize the potential benefit of using Iuvenelis, stimulating a person-centered attitude among professionals is important. Considering the small number of adolescent participants (n=7), adding quantitative data from a structured survey could strengthen the available evidence., (©Janine Benjamins, Emely de Vet, Chloe A de Mortier, Annemien Haveman-Nies. Originally published in Journal of Participatory Medicine (https://jopm.jmir.org), 23.04.2024.)

Published
2024
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98. Implementation of EPR-Youth, a Client-Accessible and Multidisciplinary Health Record; A Mixed-Methods Process Evaluation.

Author

Benjamins J, Duinkerken JG, den Hamer-Jordaan G, Canfijn R, Koster R, de Vet E, and Haveman-Nies A

Abstract

Introduction: Client-accessible interdisciplinary health records potentially contribute to integrated care by facilitating collaboration and enhancing clients' involvement in care. To achieve this, three Dutch organizations providing 'care for youth' developed a fully client-accessible electronic patient record (EPR-Youth)., Objective: To evaluate the implementation of EPR-Youth and to determine barriers and facilitators., Methods: A mixed methods design combined system data, process observations, questionnaires and focus group interviews. Target groups were parents, adolescents, professionals using EPR-Youth, and implementation stakeholders., Findings: Client-portal acceptability was high among all clients. Client-portal adoption rate was high and differed between age groups and educational levels. Professionals' doubts about acceptability, appropriateness and fidelity were partly due to lack of system knowledge. Implementation barriers were the complexity of co-creation, lack of clear leadership, and concerns about legal issues. Facilitators were clarifying vision and legal context, setting deadlines, and a pioneering spirit., Conclusion: The early implementation of EPR-Youth, the first Dutch client-accessible interdisciplinary electronic health record in 'care for youth' was successful. To enhance adoption among clients, group-specific barriers for portal-use should be determined. Professionals need additional training. Further research is needed to gain insight into client-portal access barriers. To benefit more from co-creation, an organizational change towards situational leadership is necessary., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)

Published
2023
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99. Effect of using client-accessible youth health records on experienced autonomy among parents and adolescents in preventive child healthcare and youth care: A mixed methods intervention study.

Author

Benjamins J, de Vet E, Jordaan G, and Haveman-Nies A

Abstract

Client autonomy is important in Dutch youth care. It correlates positively with mental and physical health and can be strengthened by professional autonomy-supportive behaviour. Aiming for client autonomy, three youth care organisations co-developed a client-accessible youth health record (EPR-Youth). Currently, limited research is available on how client-accessible records contribute to adolescent autonomy. We investigated whether EPR-Youth strengthened client autonomy and whether professional autonomy-supportive behaviour reinforced this effect. A mixed methods design combined baseline and follow-up questionnaires with focus group interviews. Different client groups completed questionnaires about autonomy at baseline ( n = 1404) and after 12 months ( n = 1003). Professionals completed questionnaires about autonomy-supportive behaviour at baseline ( n = 100, 82%), after 5 months ( n = 57, 57%) and after 24 months ( n = 110, 89%). After 14 months, focus group interviews were conducted with clients ( n = 12) and professionals ( n = 12). Findings show that clients using EPR-Youth experienced more autonomy than non-users. this effect was stronger among adolescents aged 16 and older than among younger adolescents. Professional autonomy-supporting behaviour did not change over time. However, clients reported that professional autonomy-supporting behaviour contributed to client autonomy, emphasising that professional attitude needs addressing during implementation of client-accessible records. Follow-up research with paired data needs to strengthen the association between using client-accessible records and autonomy.

Published
2023
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100. "Keep your distance for me": A field experiment on empathy prompts to promote distancing during the COVID-19 pandemic.

Author

de Ridder D, Aarts H, Benjamins J, Glebbeek ML, Leplaa H, Leseman P, Potgieter R, Tummers L, and Zondervan-Zwijnenburg M

Abstract

The outbreak of COVID-19 has turned out to be a major challenge to societies all over the globe. Curbing the pandemic requires rapid and extensive behavioural change to limit social interaction, including physical distancing. In this study, we tested the notion that inducing empathy for people vulnerable to the virus may result in actual distancing behaviour beyond the mere motivation to do so. In a large field experiment with a sequential case-control design, we found that (a) empathy prompts may increase distancing as assessed by camera recordings and (b) effectiveness of prompts depends on the dynamics of the pandemic and associated public health policies. In sum, the present study demonstrates the potential of empathy-generating interventions to promote pro-social behaviour and emphasizes the necessity of field experiments to assess the role of context before advising policy makers to implement measures derived from behavioural science. Please refer to Supplementary Material to find this article's Community and Social Impact Statement., (© 2021 The Authors. Journal of Community & Applied Social Psychology published by John Wiley & Sons Ltd.)

Published
2022
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