23 results on '"van Duijnhoven, Noortje T. L."'
Search Results
2. Effects of a Personal Health Record in Maternity Care: A Stepped-Wedge Trial
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Groenen, Carola J. M., primary, Kremer, Jan A. M., additional, IntHout, Joanna, additional, Meinders, Marjan J., additional, van Duijnhoven, Noortje T. L., additional, and Vandenbussche, Frank P. H. A., additional
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- 2021
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3. The effect of bed rest and an exercise countermeasure on leg venous function
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van Duijnhoven, Noortje T. L., Bleeker, Michiel W. P., de Groot, Patricia C. E., Thijssen, Dick H. J., Felsenberg, Dieter, Rittweger, Jörn, and Hopman, Maria T. E.
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- 2008
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4. The identification of genetic pathways involved in vascular adaptations after physical deconditioning versus exercise training in humans
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Lammers, Gerwen, van Duijnhoven, Noortje T. L., Hoenderop, Joost G., Horstman, Astrid M., de Haan, Arnold, Janssen, Thomas W. J., de Graaf, Mark J. J., Pardoel, Elisabeth M., Verwiel, Eugène T. P., Thijssen, Dick H. J., and Hopman, Maria T. E.
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- 2013
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5. Estimated Cost-effectiveness of Active Middle-Ear Implantation in Hearing-Impaired Patients With Severe External Otitis
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Snik, Ad F. M., van Duijnhoven, Noortje T. L., Mylanus, Emmanuel A. M., and Cremers, Cor W. R. J.
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- 2006
6. Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands
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Verfaille, Viki, de Jonge, Ank, Mokkink, Lidwine, Westerneng, Myrte, van der Horst, Henriëtte, Jellema, Petra, Franx, Arie, Bais, Joke M J, Bonsel, Gouke J., Bosmans, Judith E, van Dillen, Jeroen, van Duijnhoven, Noortje T L, Grobman, William A., Groen, Henk, Hukkelhoven, Chantal W P M, Klomp, Trudy, Kok, Marjolein, de Kroon, Marlou L., Kruijt, Maya, Kwee, Anneke, Ledda, Sabina, Lafeber, Harry N., van Lith, Jan M, Mol, Ben Willem, Molewijk, Bert, Nieuwenhuijze, Marianne, Oei, Guid, Oudejans, Cees, Paarlberg, K. Marieke, Pajkrt, Eva, Papageorghiou, Aris T., Reddy, Uma M., de Reu, Paul A O M, Rijnders, Marlies E. B., de Roon-Immerzeel, Alieke, Scheele, Connie, Scherjon, Sicco A, Snijders, Rosalinde, Teunissen, Pim W., Torij, Hanneke W., Twisk, Jos Wr, Zeeman, Kristel C., Zhang, Jun, and IRIS study group
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Practice guideline ,Prenatal ultrasonography ,Uniform approach ,Delphi technique ,Fetal growth restriction ,Obstetrics and Gynaecology ,Journal Article ,Intrauterine growth restriction ,Collaboration - Abstract
Background: Screening for, diagnosis and management of intrauterine growth restriction (IUGR) is often performed in multidisciplinary collaboration. However, variation in screening methods, diagnosis and management of IUGR may lead to confusion. In the Netherlands two monodisciplinary guidelines on IUGR do not fully align. To facilitate effective collaboration between different professionals in perinatal care, we undertook a Delphi study with uniform recommendations as our primary result, focusing on issues that are not aligned or for which specifications are lacking in the current guidelines. Methods: We conducted a Delphi study in three rounds. A purposively sampled selection of 56 panellists participated: 27 representing midwife-led care and 29 obstetrician-led care. Consensus was defined as agreement between the professional groups on the same answer and among at least 70% of the panellists within groups. Results: Per round 51 or 52 (91% - 93%) panellists responded. This has led to consensus on 27 issues, leading to four consensus based recommendations on screening for IUGR in midwife-led care and eight consensus based recommendations on diagnosis and eight on management in obstetrician-led care. The multidisciplinary project group decided on four additional recommendations as no consensus was reached by the panel. No recommendations could be made about induction of labour versus expectant monitoring, nor about the choice for a primary caesarean section. Conclusions: We reached consensus on recommendations for care for IUGR within a multidisciplinary panel. These will be implemented in a study on the effectiveness and cost-effectiveness of routine third trimester ultrasound for monitoring fetal growth. Research is needed to evaluate the effects of implementation of these recommendations on perinatal outcomes. Trial registration:NTR4367.
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- 2017
7. Effectiveness and cost-effectiveness of routine third trimester ultrasound screening for intrauterine growth restriction
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Henrichs, Jens, Verfaille, Viki, Viester, Laura, Westerneng, Myrte, Molewijk, Bert, Franx, Arie, van der Horst, Henriette, Bosmans, Judith E., de Jonge, Ank, Jellema, Petra, van Baar, Anneloes L., Bais, Joke, Bonsel, Gouke J., van Dillen, Jeroen, van Duijnhoven, Noortje T L, Grobman, William A., Groen, Henk, Hukkelhoven, Chantal W P M, Klomp, Trudy, Kok, Marjolein, de Kroon, Marlou L., Kruijt, Maya, Kwee, Anneke, Ledda, Sabina, Lafeber, Harry N., van Lith, Jan M., Mol, Ben Willem, Nieuwenhuijze, Marianne, Oei, Guid, Oudejans, Cees, Marieke Paarlberg, K., Pajkrt, Eva, Papageorghiou, Aris T., Reddy, Uma M., De Reu, Paul A O M, Rijnders, Marlies, de Roon-Immerzeel, Alieke, Scheele, Connie, Scherjon, Sicco A., Snijders, Rosalinde, Spaanderman, Marc E., Teunissen, Pim W., Torij, Hanneke W., Vrijkotte, Tanja G., Twisk, Jos, Zeeman, Kristel C., Zhang, Jun, {collab} The IRIS Study Group, The IRIS Study Group, Midwifery Science, EMGO - Quality of care, Ethics, Law & Medical humanities, General practice, Development and Treatment of Psychosocial Problems, Leerstoel Baar, Health Economics and Health Technology Assessment, EMGO+ - Mental Health, Value, Affordability and Sustainability (VALUE), Reproductive Origins of Adult Health and Disease (ROAHD), Public Health Research (PHR), Other departments, ARD - Amsterdam Reproduction and Development, Obstetrics and Gynaecology, APH - Amsterdam Public Health, Public and occupational health, and Papageorghiou, A
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Pediatrics ,Cost effectiveness ,Cost-Benefit Analysis ,law.invention ,Study Protocol ,0302 clinical medicine ,Pregnancy Outcome/economics ,Randomized controlled trial ,Clinical Protocols ,law ,Pregnancy ,Obstetrics and Gynaecology ,Prenatal ,Cluster Analysis ,030212 general & internal medicine ,Cluster randomised controlled trial ,Non-U.S. Gov't ,Qualitative Research ,Netherlands ,Ultrasonography ,030219 obstetrics & reproductive medicine ,Fetal Growth Retardation ,Obstetrics ,Prenatal/economics ,Research Support, Non-U.S. Gov't ,Pregnancy Outcome ,Obstetrics and Gynecology ,Fetal Growth Retardation/diagnostic imaging ,Randomized Controlled Trial ,Apgar score ,Female ,Pregnancy Trimester ,Quality-Adjusted Life Years ,Adult ,medicine.medical_specialty ,Pregnancy Trimester, Third ,Third trimester ultrasonography ,Research Support ,Midwifery ,Ultrasonography, Prenatal/economics ,Ultrasonography, Prenatal ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,medicine ,Journal Article ,Humans ,Fundal height ,Third ,business.industry ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Perinatal outcome ,medicine.disease ,Intrauterine growth retardation ,Quality-adjusted life year ,Bronchopulmonary dysplasia ,Quality of Life ,business - Abstract
Contains fulltext : 172417.pdf (Publisher’s version ) (Open Access) BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management. METHODS: For this trial, 15,000 women with a singleton pregnancy receiving care in 60 participating primary care midwifery practices will be included at 22 weeks of gestation. In the intervention (n = 7,500) and control group (n = 7,500) fetal growth will be monitored by serial fundal height assessments. All practices will start offering the control condition (ultrasonography based on medical indication). Every three months, 20 practices will be randomized to the intervention condition, i.e. apart from ultrasonography if indicated, two routine ultrasound examinations will be performed (at 28-30 weeks and 34-36 weeks). If IUGR is suspected, both groups will receive subsequent clinical management as described in the IRIS study protocol that will be developed before the start of the trial. The primary dichotomous clinical composite outcome is 'severe adverse perinatal outcome' up to 7 days after birth, including: perinatal death; Apgar score
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- 2016
8. Improving maternity care using a personal health record: study protocol for a stepped-wedge, randomised, controlled trial
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Groenen, Carola J. M., primary, Faber, Marjan J., additional, Kremer, Jan A. M., additional, Vandenbussche, Frank P. H. A., additional, and van Duijnhoven, Noortje T. L., additional
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- 2016
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9. Wikis to facilitate patient participation in developing information leaflets: first experiences
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van de Belt, Tom H., primary, Faber, Marjan J., additional, Knijnenburg, José M. L., additional, van Duijnhoven, Noortje T. L., additional, Nelen, Willianne L. D. M., additional, and Kremer, Jan A. M., additional
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- 2014
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10. Expression of genes involved in fatty acid transport and insulin signaling is altered by physical inactivity and exercise training in human skeletal muscle
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Lammers, Gerwen, primary, Poelkens, Fleur, additional, van Duijnhoven, Noortje T. L., additional, Pardoel, Elisabeth M., additional, Hoenderop, Joost G., additional, Thijssen, Dick H. J., additional, and Hopman, Maria T. E., additional
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- 2012
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11. The identification of genetic pathways involved in vascular adaptations after physical deconditioningversusexercise training in humans
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Lammers, Gerwen, primary, van Duijnhoven, Noortje T. L., additional, Hoenderop, Joost G., additional, Horstman, Astrid M., additional, de Haan, Arnold, additional, Janssen, Thomas W. J., additional, de Graaf, Mark J. J., additional, Pardoel, Elisabeth M., additional, Verwiel, Eugène T. P., additional, Thijssen, Dick H. J., additional, and Hopman, Maria T. E., additional
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- 2012
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12. Resistive exercise versus resistive vibration exercise to counteract vascular adaptations to bed rest
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van Duijnhoven, Noortje T. L., primary, Thijssen, Dick H. J., additional, Green, Daniel J., additional, Felsenberg, Dieter, additional, Belavý, Daniel L., additional, and Hopman, Maria T. E., additional
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- 2010
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13. Effect of functional electrostimulation on impaired skin vasodilator responses to local heating in spinal cord injury
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Van Duijnhoven, Noortje T. L., primary, Janssen, Thomas W. J., additional, Green, Daniel J., additional, Minson, Christopher T., additional, Hopman, Maria T. E., additional, and Thijssen, Dick H. J., additional
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- 2009
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14. Do infertile women and their partners have equal experiences with fertility care?
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Huppelschoten, Aleida G, van Duijnhoven, Noortje T L, van Bommel, Peter F J, Kremer, Jan A M, and Nelen, Willianne L D M
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- 2013
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15. Impact of bed rest on conduit artery remodeling: effect of exercise countermeasures.
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van Duijnhoven, Noortje T. L., Green, Daniel J., Felsenberg, Dieter, Belavý, Daniel L., Hopman, Maria T. E., Thijssen, Dick H. J., and Belavy, Daniel L
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- 2010
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16. The effect of bed rest and an exercise countermeasure on leg venous function.
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Duijnhoven, Noortje T.L., Bleeker, Michiel W.P., de Groot, Patricia C.E., Thijssen, Dick H.J., Felsenberg, Dieter, Rittweger, Jörn, Hopman, Maria T.E., van Duijnhoven, Noortje T L, and Rittweger, Jörn
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BED rest ,EXERCISE physiology ,VENOUS insufficiency ,RESONANT ultrasound spectroscopy ,THERAPEUTICS ,PHYSIOLOGY ,BLOOD circulation ,CARDIOVASCULAR system physiology ,COMPARATIVE studies ,EXERCISE ,LEG ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,ULTRASONIC imaging ,VIBRATION (Mechanics) ,CARDIOVASCULAR fitness ,EVALUATION research ,POPLITEAL vein - Abstract
This study was performed to assess the effect of resistive vibration exercise during bed rest deconditioning on venous vascular dimension and function, as measured with ultrasound in the popliteal vein. Sixteen men were assigned to bed rest (BR-Ctrl) or bed rest with resistive vibration exercise (BR-RVE). Before and at 25 and 52 days of bed rest, popliteal vein diameter was measured at increasing cuff pressures. Venous capacitance and compliance were calculated from the pressure-volume curve. After 52 days of bed rest, BR-Ctrl showed no change in baseline popliteal vein diameter or compliance, while venous capacitance decreased. Resistive vibration exercise had no effect on the response in venous diameter, capacitance or compliance to 52 days of bed rest. The decline in venous capacitance due to long-term bed rest is not effectively counteracted by resistive vibration exercise, indicating that an alternative factor during bed rest deconditioning is responsible for venous changes. [ABSTRACT FROM AUTHOR]
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- 2008
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17. Mothers' experiences of client-centred flexible planning in home-based postpartum care: A promising tool to meet their diverse and dynamic needs.
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Lambermon FJ, van Duijnhoven NTL, Kremer JAM, and Dedding CWM
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- Female, Humans, Postnatal Care, Postpartum Period, Pregnancy, Qualitative Research, Home Care Services, Mothers
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Objective: To explore mothers' perspectives and experiences when facilitating greater flexibility in the planning range of home-based postpartum care, as an innovative tool to more client-centred care., Design: A qualitative study design with semi-structured in-depth interviews., Setting: The study was executed in collaboration with a postpartum care organisation in the Netherlands. It was part of a larger research project that studied the health effects of a new way of planning home-based postpartum care. This so-called 'flexible planning' made spreading and pausing of care possible up to the 14
th day postpartum instead of the standard care planning up to the 8th day postpartum., Participants: Mothers eligible to be interviewed for this study were participants of the larger research project who were allowed to plan their care according to the flexible planning. Twenty-one mothers were recruited through purposive sampling, of which ten were first-time mothers., Findings: Mothers valued the flexible planning as the timing of care could be tailored to their personal preferences and contexts. Yet, two main challenges were found: 1. mothers experienced difficulties in communicating and translating their dynamic needs into a care planning and 2. they felt discomfort in assigning tasks to care workers. Besides, our findings showed that care workers' practical as well as their emotional support (i.e. 'doing' vs. 'being') are greatly important in responding to mothers' needs., Key Conclusions: A flexible planning is a promising tool to facilitate more client-centred care in the postpartum care period. Yet, the hectic and overwhelming nature of the first few postpartum days can complicate the forward planning of care. In addition, not knowing what to expect from the postpartum care period and having a main focus on care workers 'doing' can lead to unclear and undesired working relations., Implications for Practice: When planning care in practice, a dialogue should be held between care workers and parents in which both their fields of expertise are respected. Above all, our study elucidated that novel care innovations like ours need to be co-created directly from the start with all involved parties to truly be successful., Competing Interests: Declaration of Competing Interest No conflict of interest has been declared by the authors., (Copyright © 2021. Published by Elsevier Ltd.)- Published
- 2021
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18. The unintended consequences of client-centred flexible planning in home-based postpartum care: a shift in care workers' tasks and responsibilities.
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Lambermon FJ, van Duijnhoven NTL, Braat DDM, Kremer JAM, and Dedding CWM
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- Adult, Female, Focus Groups methods, Health Personnel statistics & numerical data, Home Care Services trends, Humans, Male, Middle Aged, Netherlands, Patient-Centered Care methods, Patient-Centered Care standards, Patient-Centered Care trends, Postnatal Care methods, Postnatal Care trends, Qualitative Research, Shift Work Schedule psychology, Shift Work Schedule standards, Shift Work Schedule statistics & numerical data, Surveys and Questionnaires, Community Health Planning methods, Health Personnel psychology, Home Care Services standards, Postnatal Care standards
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Objective: To explore care workers' experiences with a flexible planning of home-based postpartum care as an innovative instrument to facilitate more client-centred care., Design: A mixed-methods design with a primarily qualitative approach followed by a quantitative follow-up, according to the Priority-Sequence model., Setting: This study is part of a larger research project researching the health effects of a flexible planning in postpartum care. The new planning enables clients and care workers to spread and/or pause the care over 14 days postpartum instead of the standard planning of eight to ten consecutive days., Participants: Maternity home care workers who provide care according the flexible planning. Eight care workers were interviewed, another eight care workers participated in the focus group discussion, and 59 care workers filled in the survey., Findings: Two main unintended consequences of the flexible planning were found: 1. care workers experienced an undesirable 'shift in their tasks' along the course of the postpartum period and 2. were heavily worried about 'making enough contracted hours'. Consequently, care workers unwillingly performed much more domiciliary activities compared to the standard planning, especially during the final days of care., Key Conclusions: The predominant nursing tasks and responsibilities of care workers appeared insufficient to respond to clients' altering needs. In addition, shorter working days and on-call duties caused an undesired excessive high-level of flexibility among care workers. Consequently, care was paradoxically determined by organisational structures rather than clients' individual needs., Implications for Practice: Our study elucidated that co-creation together with health professionals is a prerequisite for successfully implementing innovations as their way of working and personal lives are profoundly affected., Competing Interests: Declarartion of Competing Interest No conflict of interest has been declared by the authors., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
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- 2020
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19. Shared agenda making for quality improvement; towards more synergy in maternity care.
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Groenen CJM, van Duijnhoven NTL, Kremer JAM, Scheerhagen M, Vandenbussche FPHA, and Faber MJ
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- Delphi Technique, Maternal Health Services, Patient-Centered Care, Quality Improvement
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Objectives: Professionals in maternity care have started working in a network approach. To further enhance the efficacy of this multidisciplinary maternity network, the identification of priorities for improvement is warranted. The aim of this study was to create key recommendations for the improvement agenda, in co-production with patients and professionals., Study Design: We conducted a Delphi study to inventory (round 1), prioritize (round 2) and eventually approve (round 3) the improvement agenda for the maternity network. Both patients and professionals joined this study. Initial input for the study consisted of experiences from 397 patients, collected using the ReproQ questionnaire. In round 1, the expert panel, gave improvement recommendations, based on the ReproQ results. This resulted in 11 recommendations. In the second round, the expert panel prioritised these recommendations. In the consensus meeting then finally the concrete improvement agenda was composed., Results: Priority scores differed considerably between patients and professionals in seven items, while four items received similar priority scores from both groups. The four most important improvement activities were: Realise more single bedrooms in hospitals; Create more opportunities for the continued presence of the community midwife during labour; Initiate a digital patient record view system for the network with a view function for patients; and Introduce a case manager for pregnant woman., Conclusion: Based on patient experience and the active involvement of patients and professionals, we were able to compose the shared agenda for quality improvement in maternity care., (Copyright © 2017 Elsevier B.V. All rights reserved.)
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- 2017
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20. Use of social network analysis in maternity care to identify the profession most suited for case manager role.
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Groenen CJ, van Duijnhoven NT, Faber MJ, Koetsenruijter J, Kremer JA, and Vandenbussche FP
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- Humans, Netherlands, Workforce, Case Managers, Health Personnel classification, Maternal Health Services, Patient-Centered Care, Social Support
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Objective: To improve Dutch maternity care, professionals start working in interdisciplinary patient-centred networks, which includes the patients as a member. The introduction of the case manager is expected to work positively on both the individual and the network level. However, case management is new in Dutch maternity care. The present study aims to define the profession that would be most suitable to fulfil the role of case manager., Design: The maternal care network in the Nijmegen region was determined by using Social Network Analysis (SNA). SNA is a quantitative methodology that measures and analyses patient-related connections between different professionals working in a network. To identify the case manager we focused on the position, reach, and connections in the network of the maternal care professionals., Setting: Maternity healthcare professionals in a single region of the Netherlands with an average of 4,500 births/year., Participants: The participants were 214 individual healthcare workers from eight different professions., Measurements and Findings: The total network showed 3948 connections between 214 maternity healthcare professionals with a density of 0.08. Each profession had some central individuals in the network. The 52 community-based midwives were responsible for 51% of all measured connections. The youth health doctors and nurses were mostly situated on the periphery and less connected. The betweenness centrality had the highest score in obstetricians and community-based midwives. Only the community-based midwives had connections with all other groups of professions. Almost all professionals in the network could reach other professionals in two steps., (Copyright © 2016 Elsevier Ltd. All rights reserved.)
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- 2017
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21. Expression of genes involved in fatty acid transport and insulin signaling is altered by physical inactivity and exercise training in human skeletal muscle.
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Lammers G, Poelkens F, van Duijnhoven NT, Pardoel EM, Hoenderop JG, Thijssen DH, and Hopman MT
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- 3-Hydroxyacyl CoA Dehydrogenases genetics, 3-Hydroxyacyl CoA Dehydrogenases metabolism, Adipokines genetics, Adult, Biopsy, Case-Control Studies, Fatty Acid-Binding Proteins genetics, Gene Expression Profiling, Humans, Insulin genetics, Male, Membrane Transport Proteins genetics, Membrane Transport Proteins metabolism, Muscle, Skeletal metabolism, Oligonucleotide Array Sequence Analysis, RNA chemistry, RNA genetics, Reverse Transcriptase Polymerase Chain Reaction, Signal Transduction, Spinal Cord Injuries genetics, Spinal Cord Injuries metabolism, Spinal Cord Injuries therapy, Young Adult, Adipokines metabolism, Exercise physiology, Fatty Acid-Binding Proteins metabolism, Gene Expression Regulation, Insulin metabolism, Muscle, Skeletal physiology
- Abstract
Physical deconditioning is associated with the development of chronic diseases, including type 2 diabetes and cardiovascular disease. Exercise training effectively counteracts these developments, but the underlying mechanisms are largely unknown. To gain more insight into these mechanisms, muscular gene expression levels were assessed after physical deconditioning and after exercise training of the lower limbs in humans by use of gene expression microarrays. To exclude systemic effects, we used human models for local physical inactivity (3 wk of unilateral limb suspension) and for local exercise training (6 wk of functional electrical stimulation exercise of the extremely deconditioned legs of individuals with a spinal cord injury). The most interesting subset of genes, those downregulated after deconditioning as well as upregulated after exercise training, contained 18 genes related to both the "insulin action" and "adipocytokine signaling" pathway. Of these genes, the three with strongest up/downregulation were the muscular fatty acid-binding protein-3 (FABP3), the fatty acid oxidizing enzyme hydroxyacyl-CoA dehydrogenase (HADH), and the mitochondrial fatty acid transporter solute carrier 25 family member A20 (SLC25A20). The expression levels of these genes were confirmed using RT-qPCR. The results of the present study indicate an important role for a decreased transport and metabolism of fatty acids, which provides a link between physical activity levels and insulin signaling.
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- 2012
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22. Improving patient-centeredness of fertility care using a multifaceted approach: study protocol for a randomized controlled trial.
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Huppelschoten AG, van Duijnhoven NT, Hermens RP, Verhaak C, Kremer JA, and Nelen WL
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- Delivery of Health Care, Integrated, Emotions, Feedback, Psychological, Female, Humans, Infertility physiopathology, Infertility psychology, Netherlands, Patient Satisfaction, Quality Improvement, Quality of Life, Stress, Psychological etiology, Surveys and Questionnaires, Fertility, Infertility therapy, Patient Care Team, Patient-Centered Care, Reproductive Techniques, Assisted adverse effects, Reproductive Techniques, Assisted psychology, Research Design
- Abstract
Background: Beside traditional outcomes of safety and (cost-)effectiveness, the Institute of Medicine states patient-centeredness as an independent outcome indicator to evaluate the quality of healthcare. Providing patient-centered care is important because patients want to be heard for their ideas and concerns. Healthcare areas associated with high emotions and intensive treatment periods could especially benefit from patient-centered care. How care can become optimally improved in patient-centeredness is unknown. Therefore, we will conduct a study in the context of Dutch fertility care to determine the effects of a multifaceted approach on patient-centeredness, patients' quality of life (QoL) and levels of distress. Our aims are to investigate the effectiveness of a multifaceted approach and to identify determinants of a change in the level of patient-centeredness, patients' QoL and distress levels. This paper presents the study protocol., Methods/design: In a cluster-randomized trial in 32 Dutch fertility clinics the effects of a multifaceted approach will be determined on the level of patient-centeredness (Patient-centredness Questionnaire - Infertility), patients' QoL (FertiQoL) and levels of distress (SCREENIVF). The multifaceted approach includes audit and feedback, educational outreach visits and patient-mediated interventions. Potential determinants of a change in patient-centeredness, patients' QoL and levels of distress will be collected by an addendum to the patients' questionnaire and a professionals' questionnaire. The latter includes the Organizational Culture Assessment Instrument about the clinic's culture as a possible determinant of an increase in patient-centered care., Discussion: The study is expected to yield important new evidence about the effects of a multifaceted approach on levels of patient-centeredness, patients' QoL and distress in fertility care. Furthermore, determinants associated with a change in these outcome measures will be studied. With knowledge of these results, patient-centered care and thus the quality of healthcare can be improved. Moreover, the results of this study could be useful for similar initiatives to improve the quality of care delivery. The results of this project are expected at the end of 2013., Trial Registration: Clinicialtrials.gov NCT01481064.
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- 2012
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23. Evaluation of the subjective effect of middle ear implantation in hearing-impaired patients with severe external otitis.
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Snik AF, van Duijnhoven NT, Mulder JJ, and Cremers CW
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- Adolescent, Adult, Aged, Chronic Disease, Humans, Middle Aged, Prospective Studies, Prosthesis Implantation instrumentation, Severity of Illness Index, Surveys and Questionnaires, Ear, Middle surgery, Hearing Aids, Hearing Loss, Conductive epidemiology, Hearing Loss, Conductive therapy, Otitis Externa epidemiology, Otitis Externa pathology
- Abstract
The subjective benefit of middle ear implantation was studied in a group of 23 hearing-impaired patients who could not use conventional hearing aids owing to severe chronic external otitis. Changes in hearing disability (Abbreviated Profile of Hearing Aid Benefit [APHAB]) and changes in quality of life (Glasgow Benefit Inventory [GBI]) were determined. Mean benefit value on the APHAB for the subscale Ease of Communication was close to the mean reference value for conventional hearing aids. For the subscales Reverberation and Background Noise, a poorer result was found. Individual analysis of the APHAB scores showed significant benefit in 12 out of the 23 patients. According to the GBI, 16 out of 17 patients reported that middle ear implantation had made a positive impact on their quality of life. It is concluded that middle ear implantation has a positive effect on hearing difficulties and quality of life in hearing-impaired subjects who cannot use conventional devices. The APHAB outcomes were not better than those reported for conventional devices.
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- 2007
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