| 1. |
- Jong, Miek C., 1968-, et al.
(författare)
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Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer
- 2020
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 28, s. 2415-2429
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To develop an evidence-based decision aid for parents of children with cancer and to help guide them in the use ofcomplementary and alternative medicine (CAM) for cancer care.Methods: This study had a mixed research design. The needs of parents were investigated by survey and focus group. Asystematic review and meta-analysis were performed on the effectiveness of CAM using Grading of RecommendationsAssessment, Development and Evaluation (GRADE). Clinical experts were interviewed and a decision aid on CAM treatmentfor pain was developed.Results: Parents emphasized the importance of reliable information on CAM, focusing primarily on communication and a broadspectrum of complaints related to cancer treatment. The decision aid on CAM for pain included five modalities based on 11randomized control trials (RCTs): hypnotherapy, mind-body techniques, massage, healing touch, and music therapy. Metaanalysis could be performed on hypnotherapy, which significantly reduced cancer-related procedural pain compared withstandard care (MD, − 1.37; 95% CI, − 1.60, − 1.15; P < 0.00001) and attention control (MD, − 1.13; 95% CI, − 1.34, − 0.94;P < 0.00001), and massage, demonstrating no effect on pain compared with standard care (MD, − 0.77; 95% CI, − 1.82, 0.28;P = 0.15). Research evidence and supplementary information from clinical practice and patient were incorporated in a websitebased decision aid.Conclusions: An evidence-based decision aid was developed to support parents of children with cancer in making decisions aboutCAM for pain management. Next steps will be to expand the website to include additional childhood cancer-related complaintsand to evaluate its use in practice
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| 2. |
- Jong, Miek C, et al.
(författare)
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Integration of complementary and alternative medicine in primary care : What do patients want?
- 2012
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 89:3, s. 417-422
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore patients' perspectives towards integration of Complementary and Alternative Medicine (CAM) in primary care.METHODS: A mixed-methods approach was used. This included a survey on use, attitudes and disclosure of CAM, an e-panel consultation and focus group among patients with joint diseases.RESULTS: A total of 416 patients responded to the survey who suffered from osteoarthritis (51%), rheumatoid arthritis (29%) or fibromyalgia (24%). Prevalence of CAM use was 86%, of which 71% visited a CAM practitioner. Manual therapies, acupuncture and homeopathy were most frequently used. A minority (30%) actively communicated CAM use with their General Practitioner (GP). The majority (92%) preferred a GP who informed about CAM, 70% a GP who referred to CAM, and 42% wanted GPs to collaborate with CAM practitioners. Similar attitudes were found in the focus group and upon e-panel consultation.CONCLUSIONS: Most patients in primary care want a GP who listens, inquires about CAM and if necessary refers to or collaborates with CAM practitioners.PRACTICE IMPLICATIONS: To meet needs of patients, primary care disease management would benefit from an active involvement of GPs concerning CAM communication/referral. This study presents a model addressing the role of patients and GPs within such an integrative approach.
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| 3. |
- Jong, Miek C., 1968-, et al.
(författare)
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Integrative medicine in Dutch curative and long-term healthcare centres : Mapping the field
- 2019
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Ingår i: European Journal of Integrative Medicine. - : Elsevier BV. - 1876-3820 .- 1876-3839. ; 28, s. 14-19
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Little is known about integration of Complementary and Alternative Medicine (CAM) in the Dutch healthcare system. The aim of the present study was to investigate how Integrative Medicine (IM) is practiced and how CAM is integrated with conventional medicine in curative and long-term healthcare centres in the Netherlands.Methods: A mixed methodology was applied, including a systematic internet search, an online survey and focus groups among healthcare professionals. Results: Most hospitals (92%) offered some form of CAM to treat anxiety (72%), restlessness (68%), pain (65%), sleeping problems (50%), stress (48%) and fatigue (36%). Mostly offered modalities were relaxation exercises (88%), art therapy (44%) and mindfulness (42%). Similar percentages of CAM use were found in other healthcare centres. Most CAM modalities were implemented without organizational vision, guidelines or protocols. Only 5% of implemented CAM was labelled as IM. Focus groups with health care professionals revealed the need to increase knowledge and to develop a vision for integration of CAM with conventional medicine, as well as to support effectiveness research in this area.Conclusions: This study is the first in the Netherlands to quantitatively map the extent of CAM integration in conventional health care. The number of CAM interventions offered at conventional health care settings was surprisingly high. However, integration was fragmented. Guidelines, education and research programs are needed to further integration of CAM, preferably organised in a Dutch Consortium for IM.
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| 4. |
- Jong, Miek C, 1968-, et al.
(författare)
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P04.72. Towards a model for integrative medicine in the primary care of patients with chronic joint diseases and allergy
- 2012
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Ingår i: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012. ; , s. 342-
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Konferensbidrag (refereegranskat)abstract
- PurposeIn the Netherlands, Complementary and AlternativeMedicine (CAM) is offered outside the world of mainstreammedicine. Patients would benefit from an integratedmodel in which CAM is part of main streammedicine so that disclosure of risks, benefits of CAMand credentials of CAM practitioners are sufficientlydealt with. The aim of this 4-year research project is todevelop, implement and evaluate a shared-care model ofIntegrative Medicine in a primary care setting forpatients with chronic joint diseases and allergy.MethodsThis is the first project in the Netherlands where patientorganizations, health care providers and health careinsurers collaborate to achieve an integrative health-caremodel. The project consists of four stages; in stage 1 needsand preferences of patients were investigated. Based onthis outcome, evidence in literature and clinical experiences,an integrated primary care model will be developed(stage 2). The integrated model will be piloted in two primarycare centers in the Netherlands (stage 3) and evaluatedwith respect to outcome (stage 4).ResultsStage 1: A national survey demonstrated CAM use in41% of children with allergy (eczema, asthma) and 71%of adults with chronic joint diseases (arthrosis, rheumatoidarthritis). CAM therapies mostly used werehomeopathy, manual therapies, acupuncture and naturopathy.The majority (74% allergy, 51% joint diseasesgroup) did not actively communicate CAM use withtheir family physician. However, 79% (allergy) and 70%(joint diseases) of patients preferred a physician thatinforms, refers to and collaborates with CAM.ConclusionCAM use among chronically ill patients is high. Althoughmost patients do not communicate CAM with their familyphysician, they have a high preference for a shared-caremodel in primary care. Based on these outcomes, such amodel will be developed and presented at the conference.
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| 5. |
- Jong, Miek C, 1968-, et al.
(författare)
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Pragmatic Model for Integrating Complementary and Alternative Medicine in Primary Care Management of Chronic Musculoskeletal Pain
- 2016
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Ingår i: Primary Healthcare. - : OMICS Publishing Group. - 2167-1079. ; 6:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Integration of complementary and alternative medicine (CAM) into conventional care is driven by patients’ needs for holistic care. This study aimed to develop a model for integration of CAM into primary healthcare in close collaboration with patients suffering from chronic musculoskeletal pain (CMP). Methods: The study had a qualitative inductive approach following the principles of Grounded Theory, where data were collected and generated via several data sources and steps; individual and focus group interviews and meetings with patients, general practitioners (GPs), CAM practitioners, health insurers and other key informants. Results: Consensus was reached on a model in which shared decision making was introduced to facilitate discussions on CAM between patients and GPs. Guided by evidence and best-practices, GPs refer patients to one of five selected and reimbursed CAM therapies (acupuncture, homeopathy, naturopathy, osteopathy or Tai Chi) and respective practitioner within their integrative network. CAM practitioners report treatment outcome back to the GP who follows-up on the patient for further evaluation. Conclusions: In conclusion, it was feasible to develop a model for integration of CAM into primary healthcare management of CMP that was driven by patients’ needs and obtained consensus of all stakeholders. The model is the first in the Netherlands to provide for integrative health services in primary care. It needs to be tested in a study setting before further implementation is recommended.
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| 6. |
- Josts, Inokentijs, et al.
(författare)
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Conformational States of ABC Transporter MsbA in a Lipid Environment Investigated by Small-Angle Scattering Using Stealth Carrier Nanodiscs
- 2018
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Ingår i: Structure. - : Elsevier. - 0969-2126 .- 1878-4186. ; 26:8, s. 1072-1079.e4
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Tidskriftsartikel (refereegranskat)abstract
- Structural studies of integral membrane proteins (IMPs) are challenging, as many of them are inactive or insoluble in the absence of a lipid environment. Here, we describe an approach making use of fractionally deuterium labeled "stealth carrier'' nanodiscs that are effectively invisible to low-resolution neutron diffraction and enable structural studies of IMPs in a lipidic native-like solution environment. We illustrate the potential of the method in a joint small-angle neutron scattering (SANS) and X-ray scattering (SAXS) study of the ATP-binding cassette (ABC) transporter protein MsbA solubilized in the stealth nanodiscs. The data allow for a direct observation of the signal from the solubilized protein without contribution from the surrounding lipid nanodisc. Not only the overall shape but also differences between conformational states of MsbA can be reliably detected from the scattering data, demonstrating the sensitivity of the approach and its general applicability to structural studies of IMPs.
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| 7. |
- Kristoffersen, Agnete E., et al.
(författare)
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Consultations with health care providers and use of self-management strategies for prevention and treatment of COVID-19 related symptoms. A population based cross-sectional study in Norway, Sweden and the Netherlands
- 2022
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Ingår i: Complementary Therapies in Medicine. - : Elsevier. - 0965-2299 .- 1873-6963. ; 64
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The present study was initiated to determine consultations with health care providers and use of self-management strategies for prevention or treatment of COVID-19 related symptoms in countries with a full lockdown (Norway), a partial lockdown (the Netherlands) and no lockdown (Sweden) during the first three months of the COVID-19 pandemic, and if such use correlates with worries of being infected by COVID-19 disease.Design: Data were collected in collaboration with Ipsos A/S in April-June 2020. An adapted version of the International Questionnaire to measure use of Complementary and Alternative Medicine (I-CAM-Q) was used with the categories “for prevention of COVID-19” and “to treat COVID-19-related symptoms” added. Data were collected among a representative sample in Norway, Sweden and the Netherlands using data assisted telephone interviews (Norway, n=990 and Sweden, n=500), and an online survey (the Netherlands, n=1004). Total response rate was 30%.Results: Very few consulted a health care provider with the intention to treat or prevent COVID-19 (1.2% and 1.0% respectively) with medical doctors mostly visited (1.0% and 0.9% respectively). Similarly, the use of self-management strategies to prevent or treat COVID-19 was low (3.4% and 0.2% respectively); most commonly used for prevention of COVID-19 were vitamins and minerals (2.8%). Consultations with health care providers and use of self-management strategies for prevention of COVID-19 were positively associated with worries of being infected with COVID-19.Conclusions: The COVID-19 pandemic does not seem to have evoked a large-scale difference in behavior related to consultations with health care providers or the use of self-management strategies in any of the three countries.
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| 8. |
- Nitsche, Julius, et al.
(författare)
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Structural basis for activation of plasma-membrane Ca(2+)-ATPase by calmodulin.
- 2018
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Ingår i: Communications Biology. - : Nature Publishing Group. - 2399-3642. ; 1
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Tidskriftsartikel (refereegranskat)abstract
- Plasma-membrane Ca(2+)-ATPases expel Ca(2+) from the cytoplasm and are key regulators of Ca(2+) homeostasis in eukaryotes. They are autoinhibited under low Ca(2+) concentrations. Calmodulin (CaM)-binding to a unique regulatory domain releases the autoinhibition and activates the pump. However, the structural basis for this activation, including the overall structure of this calcium pump and its complex with calmodulin, is unknown. We previously determined the high-resolution structure of calmodulin in complex with the regulatory domain of the plasma-membrane Ca(2+)-ATPase ACA8 and revealed a bimodular mechanism of calcium control in eukaryotes. Here we show that activation of ACA8 by CaM involves large conformational changes. Combining advanced modeling of neutron scattering data acquired from stealth nanodiscs and native mass spectrometry with detailed dissection of binding constants, we present a structural model for the full-length ACA8 Ca(2+) pump in its calmodulin-activated state illustrating a displacement of the regulatory domain from the core enzyme.
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| 9. |
- van der Werf, Esther T., et al.
(författare)
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Lifestyle changes during the first wave of the COVID-19 pandemic : a cross-sectional survey in the Netherlands
- 2021
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: During the Covid-19 pandemic the Dutch government implemented its so-called 'intelligent lockdown' in which people were urged to leave their homes as little as possible and work from home. This life changing event may have caused changes in lifestyle behaviour, an important factor in the onset and course of diseases. The overarching aim of this study is to determine life-style related changes during the first wave of the COVID-19 pandemic among a representative sample of the adult population in the Netherlands. Methods: Life-style related changes were studied among a random representative sample of the adult population in the Netherlands using an online survey conducted from 22 to 27 May 2020. Differences in COVID-19-related lifestyle changes between Complementary and Alternative Medicine (CAM) users and non-CAM users were determined. The survey included a modified version of the I-CAM-Q and 26 questions on lifestyle related measures, anxiety, and need for support to maintain lifestyle changes. Results: 1004 respondents were included in the study, aged between 18 and 88 years (50.7% females). Changes to a healthier lifestyle were observed in 19.3% of the population, mainly due to a change in diet habits, physical activity and relaxation, of whom 56.2% reported to be motivated to maintain this behaviour change in a post-COVID-19 era. Fewer respondents (12.3%) changed into an unhealthier lifestyle. Multivariable logistic regression analyses revealed that changing into a healthier lifestyle was positively associated with the variables 'Worried/ Anxious getting COVID-19' (OR: 1.56, 95% C.I. 1.26-1.93), 'CAM use' (OR: 2.04, 95% C.I. 1.38-3.02) and 'stress in relation to financial situation' (OR: 1.89, 95% C.I. 1.30-2.74). 'Age' (OR 18-25: 1.00, OR 25-40: 0.55, 95% C.I. 0.31-0.96, OR 40-55:0.50 95% C.I. 0.28-0.87 OR 55+: 0.1095% C.I. 0.10-0.33), 'stress in relation to health' (OR: 2.52, 95% C.I. 1.64-3.86) and 'stress in relation to the balance work and home' (OR: 1.69, 95% C.I. 1.11-2.57) were found predicting the change into an unhealthier direction. Conclusion: These findings suggest that the coronavirus crisis resulted in a healthier lifestyle in one part and, to a lesser extent, in an unhealthier lifestyle in another part of the Dutch population. Further studies are warranted to see whether this behavioural change is maintained over time, and how different lifestyle factors can affect the susceptibility for and the course of COVID-19.T
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| 10. |
- van Vliet, Marja, et al.
(författare)
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Attitudes, Beliefs, and Practices of Integrative Medicine Among Nurses in the Netherlands
- 2015
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Ingår i: Journal of Holistic Nursing. - : SAGE Publications. - 0898-0101 .- 1552-5724. ; 33:2, s. 110-121
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study assessed the attitude, beliefs, and practices of integrative medicine (IM) among nurses in the Netherlands.DESIGN: Subscribers of a Dutch nursing journal were asked to fill in an anonymous, structured, online survey related to the topic under study.RESULTS: A total of 355 people responded, of which 37% were familiar with the concept of IM in advance. On completion of the survey, the majority (83%) considered IM as a (very) important innovation in health care. Familiarity (odds ratio = 3.20; 95% confidence interval [1.48, 6.94]) and organization (nursing home compared to hospital (odds ratio = 5.98; 95% confidence interval [1.36, 26.23]) were characteristics associated with a positive attitude toward IM. Between 23% and 46% of respondents encountered obstacles regarding implementation of IM. The main obstacles were lack of support (69% to 78%), means (57% to 85%), and time (63% to 70%).CONCLUSIONS: Dutch nurses seem to have relatively positive attitudes and beliefs regarding IM. The outcome of this survey may contribute an increased awareness of the key role that nurses can play in the development and implementation of IM.
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| 11. |
- van Wietmarschen, Herman A., et al.
(författare)
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Probiotics use for antibiotic-associated diarrhea : a pragmatic participatory evaluation in nursing homes
- 2020
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Ingår i: BMC Gastroenterology. - : Springer Science and Business Media LLC. - 1471-230X. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Antibiotic-associated diarrhea (AAD) occurs in 2-25% of nursing home residents, which may lead to dehydration, malnutrition, severe complications and hospitalizations. Research shows that probiotics can be effective and safe in reducing AAD. However, probiotics are not routinely used in Dutch nursing homes. The objectives of this evaluation were to develop a procedure for the implementation of probiotics to prevent AAD in nursing homes, to evaluate effects on AAD occurrence, and to evaluate the implementation process of probiotics in daily care. METHODS: A pragmatic participatory evaluation (PPE) design was chosen, as it seemed a suitable approach for implementation of probiotics, as well as for evaluation of its effectiveness in daily nursing home practice. Probiotics administration was implemented in three nursing homes of the Rivas Zorggroep for residents with somatic and/or psychogeriatric conditions. Ninety-three residents provided data on 167 episodes of antibiotics use, of which 84 episodes that included supplementation with probiotics and 83 episodes with no probiotics supplementation. A multispecies probiotics was administered twice daily upon start of antibiotic treatment, up to 1 week after completing the antibiotics course. The occurrence of AAD was monitored and a process evaluation was conducted to assess facilitators and barriers of probiotics implementation. RESULTS: The number of episodes with AAD when using probiotics was significantly lower than when no probiotics was used (20% vs 36%; p = 0,022, Chi-square). No significant differences in the occurrence of AAD were found between the residents taking amoxicillin/clavulanic acid or ciprofloxacin. Reported facilitators for implementation were perceived benefits of probiotics and prescription by medical staff. Reported challenges were probiotics intake by residents and individual decision-making as to which resident would benefit from it. CONCLUSION: Successful implementation of probiotics demonstrated the prevention of AAD in nursing home residents. TRIAL REGISTRATION: ISRCTN 94786163, retrospectively registered on 3 February 2020.
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