Gut bacteria have influence on blood lipids levels 

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doi: 10.1161/CIRCRESAHA.115.306807
Gut bacteria influence essential factors in the prevention of heart disease. Bacteria in the gut play a role in changes in people’s weight, body fat and the amount of good cholesterol in their bodies. These are the results of research by a group of UMCG researchers led by geneticists Jingyuan Fu (Pure Research Profile); extra Google Scholar profile ) and Alexandra Zhernakova( Pure Research Profile; scholar, IDs?). They publish their findings in Circulation Research (open access article) today. For the first time the association between gut bacteria and blood lopids levels is shown; this represents an important step in the prevention of heart disease.

Jingyuan Fu, PhD Associate professor, VIDI grant holder

Alexandra (Sasha) Zhernakova, MD, PhD Rosalind Franklin Fellow

Scientists at the UMCG have been researching the link between chronic inflammation and the development of heart disease for some time now, with financial support from the Dutch heart foundation Hartstichting. People who are seriously overweight suffer from this chronic inflammation because their gut, liver and fat tissue fail to interact properly. This probably contributes to their increased risk of heart disease. The exact relationship between these factors is the subject of this broad research project, of which the study by Jingyuan Fu and Alexandra Zhernakova is the first result.

The latest DNA sequencing techniques have made it possible to gain a better understanding of gut bacteria and their role in the human body. The researchers used these techniques to study the link between gut flora and blood lipids (fatty substances in the blood) in 893 LifeLines participants.¹ Their study showed that no fewer than 34 types of gut bacteria contribute to changes in BMI, fatty acid levels in the blood and the amount of good cholesterol (HDL) in the body. This link was previously unknown. The researchers also found that the bacteria contribute very little to the amount of bad cholesterol (LDL).

The results are important because they represent a starting point for new treatments that prevent heart disease. The composition of the gut flora might be able to be influenced through food, pro- or prebiotics to such an extent that it keeps body weight, fat and cholesterol at a level that helps prevent heart disease. The researchers believe that more research will lead to more knowledge about the association between food and heart disease.

¹ LifeLines is a large biobank that stores the biomaterial of more than 167,000 participants in the LifeLines scientific research project. It provides the infrastructure for scientific research in the field of healthy ageing. LifeLines will follow the health of these 167,000 participants for a period of 30 years.

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Source: Gut bacteria have influence on blood lipids levels | News articles | News | University of Groningen

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Letter to the Editor: “Use of biomarkers to identify new drug targets and to predict risk of cardiometabolic outcomes” by Holmegard HN, et al.

Letter to the Editor: “Use of biomarkers to identify new drug targets and to predict risk of cardiometabolic outcomes” by Holmegard HN, et al.

J Clin Endocrinol Metab. 2016 Feb;101(2):L20-L21

Authors: Abbasi A

PMID: 26840109 [PubMed – as supplied by publisher]

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OTOLOGY QUESTIONNAIRE AMSTERDAM (OQUA) : De ontwikkeling van een algemene vragenlijst naar oor gerelateerde klachten.

Background: Patient reported outcome measures (PROMs) are useful in measuring quality of health care. Over the past years, many PROMs about ear-related symptoms have been developed. Most patients visiting the ear, nose and throat doctor (ENT-doctor) because of an ear-related symptom suffer from multiple ear complaints. However, there is no well-validated, Dutch PROM available that contains items about all types of ear complaints. Objective: Aim of the present study is item reduction of the third draft of the questionnaire; the ‘Otology Questionnaire Amsterdam 3’ (OQUA3). The final goal of this project is the development of the final, validated version of the OQUA. The OQUA needs to measure 8 types of ear-related symptoms and must be applicable to all adult patients visiting an ENT-doctor because of an ear complaint. Material and methods: Quantitative research. Field-testing of the OQUA3 (N=352). The OQUA3 consists of 50 items and covers 8 types of ear-related symptoms. Participating patients were above the age of 16 and presented themselves to an ENT-doctor with an ear complaint. Item reduction took place based on factor analysis and reliability analysis. Results: Nine items were removed based on factor analysis, 17 items were removed based on reliability analysis. Based on factor analysis, 9 subscales were developed. The current version of the questionnaire consists of 23 items and covers all 8 types of ear-related symptoms. Conclusion: The current version of the questionnaire is a good foundation for the final, validated version of the OQUA.

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Changes in the Gut Mycome and Microbiome during Necrotizing Enterocolitis-like Murine Intestinal Injury

INTRODUCTION – Necrotizing enterocolitis (NEC) is a gastrointestinal crisis in the newborn
infant. NEC is among the most common and devastating diseases in newborns with a mortality
up to 30% and still one of the most difficult to eradicate. NEC is therefore a priority for research.
Unfortunately, the pathophysiology of NEC is not completely understood. A multifactorial cause
is suggested in previous research, most investigative attention has remained focused on the role
of bacterial flora, and increasing evidence indicates that luminal fungi may also play a role. In
this study, the difference in the microbiome and mycobiome have been monitored using a proven
mouse model to establish the best techniques for detecting disease progression in treated versus
control mice.
MATERIAL AND METHODS – A research set up was designed and primer pairs selected. Ten
day old mouse pups were used to mimic NEC and the gut including feces was harvested for DNA
extraction. The DNA was then used for next generation sequencing in the Miseq. The DNA
sequences were analyzed using BaseSpace and QIIME.
RESULTS – The research showed some obvious differences in the microbiome between the
control versus the treated group. Where some species were only prevalent in the Control group
and other species only prevalent in the Treated group. Due to a low number of reads off the
mycobiome in the samples, no differences in the mycobiome could be detected.
CONCLUSION AND DISCUSSION – Some of the results of this research are also found in
previous research. This could indicate the pathological and/or preventive function of several
species. The mycobiome was inconclusive and more research needs to be done on this topic.

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Pitch and spectral resolution: A systematic comparison of bottom-up cues for top-down repair of degraded speech.

Pitch and spectral resolution: A systematic comparison of bottom-up cues for top-down repair of degraded speech.

J Acoust Soc Am. 2016 Jan;139(1):395

Authors: Clarke J, Başkent D, Gaudrain E

Abstract
The brain is capable of restoring missing parts of speech, a top-down repair mechanism that enhances speech understanding in noisy environments. This enhancement can be quantified using the phonemic restoration paradigm, i.e., the improvement in intelligibility when silent interruptions of interrupted speech are filled with noise. Benefit from top-down repair of speech differs between cochlear implant (CI) users and normal-hearing (NH) listeners. This difference could be due to poorer spectral resolution and/or weaker pitch cues inherent to CI transmitted speech. In CIs, those two degradations cannot be teased apart because spectral degradation leads to weaker pitch representation. A vocoding method was developed to evaluate independently the roles of pitch and spectral resolution for restoration in NH individuals. Sentences were resynthesized with different spectral resolutions and with either retaining the original pitch cues or discarding them all. The addition of pitch significantly improved restoration only at six-bands spectral resolution. However, overall intelligibility of interrupted speech was improved both with the addition of pitch and with the increase in spectral resolution. This improvement may be due to better discrimination of speech segments from the filler noise, better grouping of speech segments together, and/or better bottom-up cues available in the speech segments.

PMID: 26827034 [PubMed – in process]

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Children with health impairments by heavy metals in an e-waste recycling area.

Children with health impairments by heavy metals in an e-waste recycling area.

Chemosphere. 2016 Jan 29;148:408-415

Authors: Zeng X, Xu X, Boezen HM, Huo X

Abstract
E-waste recycling has become a global environmental health issue. Pernicious chemicals escape into the environment due to informal and nonstandard e-waste recycling activities involving manual dismantling, open burning to recover heavy metals and open dumping of residual fractions. Heavy metals derived from electronic waste (e-waste), such as, lead (Pb), cadmium (Cd), chromium (Cr), manganese (Mn), nickel (Ni), mercury (Hg), arsenic (As), copper (Cu), zinc (Zn), aluminum (Al) and cobalt (Co), differ in their chemical composition, reaction properties, distribution, metabolism, excretion and biological transmission. Our previous studies showed that heavy metal exposure have adverse effects on children’s health including lower birth weight, lower anogenital distance, lower Apgar scores, lower current weight, lower lung function, lower hepatitis B surface antibody levels, higher prevalence of attention-deficit/hyperactivity disorder, and higher DNA and chromosome damage. Heavy metals influence a number of diverse systems and organs, resulting in both acute and chronic effects on children’s health, ranging from minor upper respiratory irritation to chronic respiratory, cardiovascular, nervous, urinary and reproductive disease, as well as aggravation of pre-existing symptoms and disease. These effects of heavy metals on children’s health are briefly discussed.

PMID: 26829309 [PubMed – as supplied by publisher]

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How to think about your drink: Action-identification and the relation between mindfulness and dyscontrolled drinking.

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How to think about your drink: Action-identification and the relation between mindfulness and dyscontrolled drinking.

Addict Behav. 2016 Jan 14;56:51-56

Authors: Schellhas L, Ostafin BD, Palfai TP, de Jong PJ

Abstract
Cross-sectional and intervention research have shown that mindfulness is inversely associated with difficulties in controlling alcohol use. However, little is known regarding the mechanisms through which mindfulness is related to increased control over drinking. One potential mechanism consists of the way individuals represent their drinking behaviour. Action identification theory proposes that self-control of behaviour is improved by shifting from high-level representations regarding the meaning of a behaviour to lower-level representations regarding “how-to” aspects of a behaviour. Because mindfulness involves present-moment awareness, it may help to facilitate such shifts. We hypothesized that an inverse relation between mindfulness and dyscontrolled drinking would be partially accounted for by the way individuals mentally represent their drinking behaviour – i.e., reduced levels of high-level action identification and increased levels of low-level action identification. One hundred and twenty five undergraduate psychology students completed self-report measures of mindful awareness, action identification of alcohol use, and difficulty in controlling alcohol use. Results supported the hypothesis that high-level action identification partially mediates the relation between mindfulness and dyscontrolled drinking but did not support a mediating role for low-level action identification. These results suggest that mindfulness can improve self-control of alcohol by changing the way we think about our drinking behaviour.

PMID: 26812278 [PubMed – as supplied by publisher]

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Hydrogen sulfide in hypertension.

Hydrogen sulfide in hypertension.

Curr Opin Nephrol Hypertens. 2016 Jan 22;

Authors: van Goor H, van den Born JC, Hillebrands JL, Joles JA

Abstract
PURPOSE OF REVIEW: Hypertension is an important determinant of cardiovascular disease, and strict blood pressure regulation is beneficially associated with the risk for cardiovascular events or all-cause mortality. However, intensive antihypertensive treatment is not always sufficient to reach normotension. Hydrogen sulfide (H2S) is a gaseous signalling molecule with antihypertensive properties. It is endogenously produced, but can also be exogenously administrated. The current review provides an overview on H2S research performed in the context of hypertension and cardiovascular disease.
RECENT FINDINGS: H2S has been increasingly found to contribute to different (patho-)physiological processes such as blood pressure regulation and scavenging of reactive oxygen species. A deficiency of H2S-producing enzymes results in hypertension, and administration of H2S donors lowers blood pressure and protects against organ damage in the experimental setting. Thiosulfate, a H2S metabolite, can act as a H2S donor, and is already clinically used for the treatment of calciphylaxis in patients with end-stage renal disease. Treatment of hypertensive rats with thiosulfate results in lower blood pressure and reduces organ damage.
SUMMARY: Although human data on H2S and hypertension are scarce, experimental data indicate that elevation of H2S levels using dietary sulfate or exogenous H2S (donors) could be a promising therapeutic strategy in the setting of hypertension.

PMID: 26808704 [PubMed – as supplied by publisher]

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Vision-Related Quality of Life in Patients with Inactive HLA-B27-Associated-Spectrum Anterior Uveitis.

Vision-Related Quality of Life in Patients with Inactive HLA-B27-Associated-Spectrum Anterior Uveitis.

PLoS One. 2016;11(1):e0146956

Authors: Hoeksema L, Los LI

Abstract
We investigated the vision-related quality of life (VR-QOL) in patients with HLA-B27 associated anterior uveitis (AU). The study was conducted in 2012 at the ophthalmology department of the University Medical Center of Groningen. We included AU patients who were HLA-B27 positive and/or were diagnosed by a rheumatologist with an HLA-B27 associated systemic disease. Sixty-one of 123 (50%) adult patients participated. All patients filled-out the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25), Beck Depression Inventory (BDI-II), social support lists and an additional questionnaire for gathering general information. Medical records were reviewed for clinical characteristics. Analyses were conducted on various patient and ocular characteristics. We compared our NEI VFQ-25 scores with those previously found in the literature. Our main outcome measures were VR-QOL scores and their associations with various general patient and ocular characteristics. We found that the NEI VFQ-25 mean overall composite score was 88.9±8.8, which is relatively high, but lower than that found in a normal working population. The mean general health score was 47.4±20.8, which is lower than in patients with other ocular diseases. Patients with a systemic disease scored significantly lower on general health and VR-QOL, compared to patients without a systemic disease. Patients with a depression (6/59 (10%)) frequently had ankylosing spondylitis (5/6 patients) and they scored significantly worse on VR-QOL. We concluded that patients with HLA-B27 associated AU have a relatively high VR-QOL. However, the presence of a systemic disease is associated with lower VR-QOL and general health scores. In addition, depression is associated with a lower VR-QOL.

PMID: 26808922 [PubMed – as supplied by publisher]

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Waar ligt de informatiebehoefte van patienten voorafgaand aan een ileo- of colostoma met spoed?

Hedendaags hebben wereldwijd ongeveer 1,3 miljoen mensen een ileo- of colostoma. In het Universitair Medisch Centrum Groningen (UMCG) hebben in 2014 146 patiënten een ileostoma en 62 patiënten een colostoma gekregen op de verpleegafdeling abdominale chirurgie. Jaarlijks krijgen circa 55 patiënten met spoed een stoma aangelegd in het UMCG. De aanleiding van dit onderzoek naar de informatiebehoefte van patiënten, wanneer zij met spoed een ileo- of een colostoma krijgen, is het feit dat er geen eenduidige werkwijze is omtrent het voorlichtingsgesprek bij een patiënt die met spoed een ileo- of colostoma krijgt. Wanneer iemand met spoed een ileo- of colostoma krijgt heeft de stomaverpleegkundige te weinig tijd om alle onderwerpen van de richtlijn van V&VN stomazorg naar voren te laten komen in het voorlichtingsgesprek. Omdat de stomaverpleegkundigen in dit geval niet goed weten aan welke informatie een patiënt in geval van spoed behoefte heeft is de volgende onderzoeksvraag opgesteld: ‘Waar ligt de informatiebehoefte van patiënten in de preoperatieve fase wanneer deze met spoed een ileo- of colostoma krijgen op de afdeling abdominale chirurgie van het Universitair Medisch Centrum Groningen?’
Het doel van dit onderzoek is het in kaart brengen van de informatiebehoefte van een patiënt wanneer deze met spoed een ileo- of colostoma krijgt. Voor zowel de stomaverpleegkundige als voor de patiënt is het belangrijk dat er een eenduidige werkwijze komt wat betreft de voorlichtingsgesprekken om op deze manier de kwaliteit van zorg te waarborgen.
Het onderzoeksdesign voor dit afstudeeronderzoek betreft een kwalitatief onderzoek. Dit kwalitatief onderzoek wordt door Jansen (2011) het best getypeerd met de term ‘kwalitatief surveyonderzoek’.
Het kwalitatieve onderzoek is uitgevoerd onder patiënten boven de achttien jaar, die met spoed een ileo- of colostoma gekregen hebben in het jaar 2014 op de afdeling abdominale chirurgie van het UMCG. In het onderzoek is de data verzameld door middel van het afnemen van interviews bij de respondenten. De interviews zijn telefonisch afgenomen bij de respondenten. Het interview is gestart met een aantal open vragen om zoveel mogelijk informatie te verzamelen. Hierna is het interview overgegaan in semigestructureerd waarbij een aantal stellingen aan de respondenten is voorgelegd. Met behulp van de acht stappen van Verhoeven (2014) is de data geanalyseerd. De open vragen van de topiclijst is met gebruikmaking van ATLAS-ti gecodeerd en geanalyseerd. Het kwantitatieve data, verkregen uit de stellingen, is met behulp van Excel geanalyseerd.
De resultaten zijn verkregen door middel van het beantwoorden van stellingen met een Likertschaal. Op geen enkele stelling is unaniem gereageerd. Dat maakt het moeilijk om de resultaten te generaliseren. Daarnaast was de steekproefomvang relatief klein en zat hier niet de gewenste variatie in. Verder is uit de open vragen die gesteld zijn tijdens het interview is relatief weinig bruikbare data gekomen.
De resultaten van dit onderzoek suggereren dat de informatiebehoefte, van patiënten in de preoperatieve fase wanneer deze met spoed een ileo- of colostoma krijgen, ligt bij voorlichting over de mogelijke gevolgen van de operatie, de gevolgen van het hebben van een stoma, uitleg over de gestelde diagnose, het ziektebeeld en erfelijkheid, en tot slot ligt de behoefte in vele gevallen bij voorlichting over het aantal dagen dat verwacht wordt in het ziekenhuis te moeten.
De onderzoekers bevelen de praktijk aan om met de resultaten van dit onderzoek een valide voorlichtingslijst samen te stellen. Door het samenstellen van een voorlichtingslijst kan er in spoed situaties effectief voorlichting gegeven worden aan de patiënt.

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Het werk van de transferverpleegkundige : Een kwalitatief onderzoek naar de kwaliteit van het contact en samenwerking tussen transferverpleegkundigen en het socialenetwerk van de zorgvrager

Aanleiding: vanuit het Universitair Medisch Centrum Groningen is de vraag gekomen of de reorganisatie van zorg, de hogere eisen en toename van keuzevrijheid invloed heeft op kwaliteit van het contact en samenwerking tussen transferverpleegkundigen en het betrokken sociale netwerk van zorgvragers voor wie nazorg georganiseerd moet worden.
Theoretisch kader: sinds januari 2015 is er veel verandert omtrent de zorg en ondersteuning van zorgbehoeftigen. Dit vanwege toenemende vergrijzing, hogere pensioenleeftijd en personeelstekorten in de zorg. Om deze reden is er een reële dreiging dat langdurige zorg in de toekomst onbetaalbaar zou kunnen worden. De overheid heeft daarom besloten de zorg per 2015 anders te organiseren met als gevolg dat er nu en in de toekomst meer geparticipeerd verwacht wordt vanuit het sociale netwerk van de zorgvrager.
Vraag- en doelstelling: De vraagstelling luidt als volgt, hoe ervaren transferverpleegkundigen in het UMCG hun rol in het contact en de samenwerking met het betrokken sociale netwerk van zorgvragers voor wie nazorg georganiseerd moet worden en welke factoren zijn van invloed op de werkzaamheden van de transferverpleegkundige op het gebied van contact en samenwerking? Met als doelstelling; Er is inzicht verkregen hoe de transferverpleegkundige hun rol in het contact en de samenwerking ervaren met het sociale netwerk van zorgvragers voor wie nazorg georganiseerd moet worden en welke factoren van invloed zijn op dit contact en deze samenwerking, opdat het UMCG mogelijk maatregelen kan treffen om de kwaliteit van zorg te verbeteren.
Methode: dit onderzoek kent een kwalitatief karakter. Aan de hand van een niet-gerichte aselecte steekproef zijn zeven transferverpleegkundigen uit verschillende sectoren binnen het UMCG geselecteerd en vervolgens geïnterviewd.
Resultaten: de communicatie en samenwerking met zorgvrager en diens netwerk worden over het algemeen door de transferverpleegkundige als positief ervaren. De transferverpleegkundigen hebben te maken met negatieve factoren zoals hoge werkdruk en hoge verwachtingen mede veroorzaakt door andere disciplines. De transitie van zorg heeft voor zowel positieve als negatieve veranderingen gezorgd.
Discussie: omdat het onderzoek een exploratief karakter heeft is er weinig vergelijking gevonden met andere literatuur. Mensen zijn door de jaren wel veeleisender en mondiger geworden. De transferverpleegkundigen geven aan het fijn te vinden dat zorgvragers en diens netwerk mondiger zijn en proberen mee te denken met het ontslagproces.
Conclusie: De transferverpleegkundigen hebben veel plezier in hun werk en proberen te regelen wat ze kunnen regelen voor de zorgvrager. Ze vinden het wel vervelend dat hun rol onderschat wordt door andere disciplines, waardoor er onjuiste verwachtingen geschept worden. Hierin kan meer duidelijkheid gecreëerd worden.
Aanbevelingen: bij dit onderzoek is er veel gekeken naar de rol en ervaringen van transferverpleegkundigen. Om een goed beeld te krijgen adviseren wij om een tevredenheidsonderzoek vanuit de zorgvragers uit te voeren om hiermee duidelijk in beeld te krijgen hoe de zorgvragers het ontslagproces hebben ervaren. Deze uitkomsten kunnen met elkaar vergeleken worden om te kijken of een nazorgtraject nog efficiënter kan worden ingevuld. Ook kan er een protocol gemaakt worden met duidelijk richtlijnen wanneer en hoe de transferverpleegkundigen ingeschakeld kunnen worden.

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Heavy metals in PM2.5 and in blood, and children’s respiratory symptoms and asthma from an e-waste recycling area.

Related Articles

Heavy metals in PM2.5 and in blood, and children’s respiratory symptoms and asthma from an e-waste recycling area.

Environ Pollut. 2016 Jan 21;210:346-353

Authors: Zeng X, Xu X, Zheng X, Reponen T, Chen A, Huo X

Abstract
This study was to investigate the levels of heavy metals in PM2.5 and in blood, the prevalence of respiratory symptoms and asthma, and the related factors to them. Lead and cadmium in both PM2.5 and blood were significant higher in Guiyu (exposed area) than Haojiang (reference area) (p < 0.05), however, no significant difference was found for chromium and manganese in PM2.5 and in blood. The prevalence of cough, phlegm, dyspnea, and wheeze of children was higher in Guiyu compared to Haojiang (p < 0.05). No significant difference was found for the prevalence of asthma in children between Guiyu and Haojiang. Living in Guiyu was positively associated with blood lead (B = 0.196, p < 0.001), blood cadmium (B = 0.148, p < 0.05) and cough (OR, 2.37; 95% CI, 1.30-4.32; p < 0.01). Blood lead>5 μg/dL was significantly associated with asthma (OR, 9.50; 95% CI, 1.16-77.49). Higher blood chromium and blood manganese were associated with more cough and wheeze, respectively. Our data suggest that living in e-waste exposed area may lead to increased levels of heavy metals, and accelerated prevalence of respiratory symptoms and asthma.

PMID: 26803791 [PubMed – as supplied by publisher]

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Continuous usage of a hair dye product containing 2-methoxymethyl-p-phenylenediamine by hair dye allergic individuals.

Continuous usage of a hair dye product containing 2-methoxymethyl-p-phenylenediamine by hair dye allergic individuals.

Br J Dermatol. 2016 Jan 8;

Authors: Kock M, Coenraads PJ, Blömeke B, Goebel C

Abstract
BACKGROUND: Despite a positive patch test reaction to p-phenylenediamine (PPD) and/or toluene-2,5-diamine (PTD) many people attempt to continue dyeing their hair with products containing PPD or its derivatives.
OBJECTIVES: Investigation of elicitation reactions among PPD/PTD allergic individuals to hair dye products containing the less-sensitizing PPD-derivative 2-methoxymethyl-p-phenylenediamine (ME-PPD).
METHODS: Elicitation reactions were studied in 43 PPD/PTD allergic individuals by a 45-min pre-test with a ME-PPD containing hair dye on their forearm and upon negative result followed by exposure to subsequent hair colour treatment(s).
RESULTS: 38/43 PPD/PTD allergic individuals did not develop an elicitation reaction during the pre-test with ME-PPD containing hair dye products and were eligible for subsequent hair colour treatments. Of these 38 PPD/PTD allergic individuals 29 tolerated subsequent hair dyeing with ME-PPD containing hair dye products while 9 showed mild to moderate allergic reactions upon the first hair colour treatment.
CONCLUSIONS: Hair dye products with the less sensitizing ME-PPD were tolerated by 29/43 (67%) PPD/PTD allergic individuals throughout continued hair dyeing with an average of 9 treatments per year. Five individuals reacted upon pre-testing while only mild to moderate skin reactions occurred upon hair dyeing in 9 individuals who were not identified by the pre-test. To our knowledge this is the first study among PPD/PTD allergic individuals indicating that a negative 45 min pre-testing with a hair dye product helps to avoid severe allergic reactions. This article is protected by copyright. All rights reserved.

PMID: 26749506 [PubMed – as supplied by publisher]

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First European consensus for diagnosis, management, and treatment of transthyretin familial amyloid polyneuropathy.

First European consensus for diagnosis, management, and treatment of transthyretin familial amyloid polyneuropathy.

Curr Opin Neurol. 2016 Jan 5;

Authors: Adams D, Suhr OB, Hund E, Obici L, Tournev I, Campistol JM, Slama MS, Hazenberg BP, Coelho T, from the European Network for TTR-FAP (ATTReuNET)

Abstract
PURPOSE OF REVIEW: Early and accurate diagnosis of transthyretin familial amyloid polyneuropathy (TTR-FAP) represents one of the major challenges faced by physicians when caring for patients with idiopathic progressive neuropathy. There is little consensus in diagnostic and management approaches across Europe.
RECENT FINDINGS: The low prevalence of TTR-FAP across Europe and the high variation in both genotype and phenotypic expression of the disease means that recognizing symptoms can be difficult outside of a specialized diagnostic environment. The resulting delay in diagnosis and the possibility of misdiagnosis can misguide clinical decision-making and negatively impact subsequent treatment approaches and outcomes.
SUMMARY: This review summarizes the findings from two meetings of the European Network for TTR-FAP (ATTReuNET). This is an emerging group comprising representatives from 10 European countries with expertise in the diagnosis and management of TTR-FAP, including nine National Reference Centres. The current review presents management strategies and a consensus on the gold standard for diagnosis of TTR-FAP as well as a structured approach to ongoing multidisciplinary care for the patient. Greater communication, not just between members of an individual patient’s treatment team, but also between regional and national centres of expertise, is the key to the effective management of TTR-FAP.

PMID: 26734952 [PubMed – as supplied by publisher]

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Recommendations for presymptomatic genetic testing and management of individuals at risk for hereditary transthyretin amyloidosis.

Recommendations for presymptomatic genetic testing and management of individuals at risk for hereditary transthyretin amyloidosis.

Curr Opin Neurol. 2016 Jan 5;

Authors: Obici L, Kuks JB, Buades J, Adams D, Suhr OB, Coelho T, Kyriakides T, from the European Network for TTR-FAP (ATTReuNET)

Abstract
PURPOSE OF REVIEW: These recommendations highlight recent experience in genetic counselling for the severe autosomal-dominant, late-onset transthyretin familial amyloid polyneuropathy (TTR-FAP) disease, and present a structured approach towards identification and monitoring of asymptomatic carriers of the mutated gene.
RECENT FINDINGS: The effectiveness of current treatment options is still limited in patients with TTR-FAP beyond stage I. Diagnosis in the early stages of TTR-FAP is essential to prevent or delay the progression of disease. Existing legal and cultural issues differ among countries within Europe. Experts of the European Network for TTR-FAP (ATTReuNET) concluded that genetic counselling for diagnosed individuals and at-risk family members is mostly beneficial and should be carried out with care by trained professionals. Systematic and regular monitoring of an asymptomatic carrier is necessary to detect early signs of TTR-FAP and maximize the effectiveness of treatment. This includes five areas of assessment: history/clinical examination, sensorimotor function, autonomic dysfunction, cardiac function, and renal function. At least two related symptoms and positive biopsy findings are required to confirm diagnosis of TTR-FAP.
SUMMARY: Early detection of TTR-FAP is essential to improve the prognosis of TTR-FAP. ATTReuNET recommends genetic counselling and routine monitoring for asymptomatic carriers of TTR-FAP.

PMID: 26734953 [PubMed – as supplied by publisher]

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Serum paraoxonase-1 activity and risk of incident cardiovascular disease: The PREVEND study and meta-analysis of prospective population studies.

Serum paraoxonase-1 activity and risk of incident cardiovascular disease: The PREVEND study and meta-analysis of prospective population studies.

Atherosclerosis. 2015 Dec 19;245:143-154

Authors: Kunutsor SK, Bakker SJ, James RW, Dullaart RP

Abstract
BACKGROUND: Paraoxonase-1 (PON-1) has been suggested to be associated with cardiovascular disease (CVD) risk, however, aspects of the association, such as shape and independence from conventional risk factors are still uncertain. We aimed to assess the association of PON-1 with CVD risk and determine its potential utility for CVD risk prediction.
METHODS: PON-1 was measured as its arylesterase activity at baseline in the PREVEND prospective study of 6902 participants.
RESULTS: During a mean follow-up of 9.3 years, 730 CVD events were recorded. Serum PON-1 was weakly correlated with several cardiovascular risk markers including high-density lipoprotein cholesterol (HDL-C) (r = 0.18; P < 0.001) and was approximately log-linearly associated with CVD risk. In analyses adjusted for conventional risk factors, the hazard ratio (95% CI) for CVD per 1 standard deviation (SD) increase in loge PON-1 was 0.92 (0.85-0.99; P = 0.020), which remained persistent after additional adjustment for potential confounders 0.93 (0.86-0.99; P = 0.037). The association was attenuated on further adjustment for HDL-C 0.95 (0.88-1.02; P = 0.153). In a meta-analysis of 6 population-based prospective studies involving 15 064 participants and 2958 incident CVD outcomes, the pooled multivariable adjusted (including HDL-C) relative risk (95% CI) for CVD was 0.95 (0.90-1.02; P = 0.138) per 1 SD increase in PON-1 values. Adding PON-1 to a CVD risk prediction model containing conventional risk factors did not improve the C-index or net reclassification.
CONCLUSIONS: There is an approximately log-linear inverse association between PON-1 activity and CVD risk, which is partly dependent on HDL-C levels. In addition, serum PON-1 activity provides no significant improvement in CVD risk assessment beyond conventional CVD risk factors.

PMID: 26724525 [PubMed – as supplied by publisher]

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Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult.

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Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult.

Neuroscience. 2015 Dec 16;

Authors: Heeringa AN, Stefanescu RA, Raphael Y, Shore SE

Abstract
Vesicular glutamate transporters 1 and 2 (VGLUT1 and VGLUT2) have distinct distributions in the cochlear nucleus that correspond to the sources of the labeled terminals. VGLUT1 is mainly associated with terminals of auditory nerve fibers, whereas VGLUT2 is mainly associated with glutamatergic terminals deriving from other sources that project to the cochlear nucleus (CN), including somatosensory and vestibular terminals. Previous studies in guinea pig have shown that cochlear damage results in a decrease of VGLUT1-labeled puncta and an increase in VGLUT2-labeled puncta. This indicates cross-modal compensation that is of potential importance in somatic tinnitus. To examine whether this effect is consistent across species and to provide a background for future studies, using transgenesis, the current study examines VGLUT expression profiles upon cochlear insult by intracochlear kanamycin injections in the mouse. Intracochlear kanamycin injections abolished ipsilateral ABR responses in all animals and reduced ipsilateral spiral ganglion neuron densities in animals that were sacrificed after four weeks, but not in animals that were sacrificed after three weeks. In all unilaterally deafened animals, VGLUT1 density was decreased in CN regions that receive auditory nerve fiber terminals, i.e. in the deep layer of the dorsal cochlear nucleus (DCN), in the interstitial region where the auditory nerve enters the CN, and in the magnocellular region of the antero- and posteroventral CN. In contrast, density of VGLUT2 expression was upregulated in the fusiform cell layer of the DCN and in the granule cell lamina, which are known to receive somatosensory and vestibular terminals. These results show that a cochlear insult induces cross-modal compensation in the cochlear nucleus of the mouse, confirming previous findings in guinea pig, and that these changes are not dependent on the occurrence of spiral ganglion neuron degeneration.

PMID: 26705736 [PubMed – as supplied by publisher]

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Pnu Transporters: Ain’t They SWEET?

Pnu Transporters: Ain’t They SWEET?

Trends Biochem Sci. 2015 Dec 12;

Authors: Jaehme M, Guskov A, Slotboom DJ

PMID: 26692123 [PubMed – as supplied by publisher]

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Self-expressed strengths and resources of children of parents with a mental illness: A systematic review.

Self-expressed strengths and resources of children of parents with a mental illness: A systematic review.

Int J Ment Health Nurs. 2015 Dec 22;

Authors: Drost LM, van der Krieke L, Sytema S, Schippers GM

Abstract
The aim of the present study was to explore the strengths children reported to have acquired while coping with their parents illness, and the external factors these children indicated had facilitated their coping process. A systematic literature search was conducted of peer-reviewed papers that focused on self-reported experiences of children with parents who had mental illness, and revealed their strengths and resources. The search included the following databases: MEDLINE, PsycINFO, and CINAHL. Results were filtered according to whether search terms appeared in the title or abstract. Fifty-seven full-text papers were reviewed; 26 of them met the inclusion criteria and were included in the review. The statements were analysed using content analysis. The search identified 160 relevant statements, 38 (24%) of which could be described as self-reported strengths, and 122 (76%) as self-reported resources. According to these statements, the children described themselves as more mature, independent, and empathic than their peers who did not have a parent with a mental illness, and as having acquired several abilities. The statements about resources indicated that the children regarded social support, information, and particularly the support of mental health-care professionals as helpful when living with a parent with a mental illness. Recommendations for nursing actions to support children’s ability to cope with their parents’ illness are outlined.

PMID: 26692281 [PubMed – as supplied by publisher]

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OR 1087-2914 OR 0002-9262 OR 0749-3797 OR 0090-0036 OR 1232-1966 OR 1047-2797 OR 0163-7525 OR 0042-9686 OR 0957-5243 OR 1055-9965 OR 0114-5916 OR 0091-6765 OR 1476-069X OR 0013-9351 OR 0950-2688 OR 0193-936X OR 1044-3983 OR 0393-2990 OR 1101-1262 OR 0741-0395 OR 1654-9880 OR 1369-6513 OR 1353-8292 OR 0840-6529 OR 0899-823X OR 0300-5771 OR 1476-072X OR 1438-4639 OR 1661-8556 OR 1054-139X OR 0895-4356 OR 0143-005X OR 1559-0631 OR 1741-3842 OR 1351-0711 OR 1478-7954 OR 0091-7435 OR 1389-4986 OR 1075-2730 OR 1662-4246 OR 1403-4948 OR 0355-3140 OR 0964-4563 OR 0512-3054 OR 0065-2776 OR 0732-0582 OR 1568-9972 OR 0889-1591 OR 0952-7915 OR 0014-2980 OR 1476-0584 OR 1074-7613 OR 0105-2896 OR 0883-0185 OR 0896-8411 OR 0022-1767 OR 1662-811X OR 1933-0219 OR 1529-2908 OR 1474-1733 OR 1044-5323 OR 1471-4906 OR 0269-9370 OR 1139-6121 OR 1058-4838 OR 1198-743X OR 1746-630X OR 0951-7375 OR 1080-6040 OR 1560-7917 OR 0019-9567 OR 0924-8579 OR 0305-7453 OR 0022-1899 OR 0163-4453 OR 1758-2652 OR 1525-4135 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OR 0820-3946 OR 0891-1150 OR 1469-493X OR 0300-7995 OR 1866-0452 OR 0014-2972 OR 0971-5916 OR 1368-5031 OR 1449-1907 OR 1828-0447 OR 0954-6820 OR 0098-7484 OR 0140-6736 OR 0025-6196 OR 0025-7125 OR 0025-729X OR 0025-7974 OR 0300-2977 OR 0028-4793 OR 1526-2375 OR 1549-1676 OR 1460-2725 OR 1868-596X OR 0066-4219 OR 0143-5221 OR 2157-1422 OR 1566-5240 OR 1757-4676 OR 1462-3994 OR 1550-7033 OR 1582-1838 OR 0021-9738 OR 0022-1007 OR 0946-2716 OR 1942-0862 OR 0098-2997 OR 1076-1551 OR 1078-8956 OR 1750-1172 OR 1946-6234 OR 1550-8943 OR 1838-7640 OR 1471-4914 OR 1939-5116 OR 1742-7061 OR 1758-5082 OR 0142-9612 OR 1473-2262 OR 1616-5187 OR 0065-2911 OR 0066-4227 OR 0066-4804 OR 1462-5814 OR 0893-8512 OR 1040-841X OR 1369-5274 OR 0070-217X OR 1462-2912 OR 0168-6445 OR 1746-0913 OR 0095-1137 OR 2150-7511 OR 1092-2172 OR 0950-382X OR 1740-1526 OR 1434-4610 OR 0966-842X OR 0077-8923 OR 1742-5689 OR 2041-1723 OR 0028-0836 OR 0028-1042 OR 0386-2208 OR 0027-8424 OR 1364-5021 OR 1364-503X OR 1932-6203 OR 2045-2322 OR 1537-744X OR 0036-8075 OR 1552-5260 OR 1758-9193 OR 0364-5134 OR 0006-8950 OR 1935-861X OR 0896-0267 OR 0333-1024 OR 1172-7047 OR 1567-2050 OR 1528-4042 OR 1350-7540 OR 0013-9580 OR 1351-5101 OR 0924-977X OR 1461-1457 OR 1866-1947 OR 0340-5354 OR 0269-8811 OR 1474-4422 OR 0885-3185 OR 1352-4585 OR 1759-4758 OR 1660-2854 OR 1364-6745 OR 0028-3878 OR 0960-8966 OR 1522-8517 OR 1073-8584 OR 1933-7213 OR 0161-8105 OR 1389-9457 OR 1087-0792 OR 0147-006X OR 0165-0173 OR 1047-3211 OR 0959-4388 OR 0014-4886 OR 1662-5102 OR 0894-1491 OR 1050-9631 OR 1742-2094 OR 0270-6474 OR 1756-6606 OR 0893-7648 OR 1097-6256 OR 1471-003X OR 0969-9961 OR 1535-1084 OR 0896-6273 OR 0301-0082 OR 0166-2236 OR 1053-8119 OR 0925-4927 OR 1527-7941 OR 1062-3264 OR 0002-936X OR 1038-5282 OR 1099-8004 OR 0730-7659 OR 0162-220X OR 0961-5423 OR 1474-5151 OR 1462-3889 OR 0147-9563 OR 1445-8330 OR 0020-7489 OR 0309-2402 OR 0889-4655 OR 0962-1067 OR 0890-3344 OR 1526-9523 OR 0002-0443 OR 0966-0429 OR 1527-6546 OR 0891-5245 OR 0029-6554 OR 0029-6562 OR 0190-535X OR 1524-9042 OR 0160-6891 OR 1545-102X OR 0002-9165 OR 0199-9885 OR 0007-1145 OR 1363-1950 OR 1555-8932 OR 1479-5868 OR 0307-0565 OR 0002-8223 OR 0022-3166 OR 0955-2863 OR 0939-4753 OR 0954-4224 OR 0029-6643 OR 1930-7381 OR 0029-6651 OR 0163-7827 OR 0002-9378 OR 1470-0328 OR 0095-5108 OR 0010-7824 OR 1040-872X OR 0015-0282 OR 0090-8258 OR 1355-4786 OR 0378-5122 OR 1072-3714 OR 0029-7844 OR 0143-4004 OR 0197-3851 OR 1472-6483 OR 1526-8004 OR 0002-9394 OR 0003-9950 OR 0007-1161 OR 1040-8738 OR 0014-4835 OR 0146-0404 OR 0886-3350 OR 1081-597X OR 1534-7362 OR 1542-0124 OR 0161-6420 OR 1350-9462 OR 0275-004X OR 0039-6257 OR 1745-3674 OR 0363-5465 OR 0749-8063 OR 0009-921X OR 0341-2695 OR 1067-151X OR 0021-9355 OR 0301-620X OR 0736-0266 OR 1058-2746 OR 1063-4584 OR 1529-9430 OR 0886-4470 OR 1420-3030 OR 1749-4478 OR 0179-051X OR 0196-0202 OR 1043-3074 OR 1525-3961 OR 0023-852X OR 1531-7129 OR 0001-6322 OR 1072-4109 OR 0002-9173 OR 0002-9440 OR 1553-4006 OR 1015-6305 OR 1934-662X OR 1754-8403 OR 1473-7159 OR 0309-0167 OR 1525-1578 OR 0022-3069 OR 0022-3417 OR 0023-6837 OR 0893-3952 OR 0305-1846 OR 1863-2297 OR 0001-2815 OR 1876-2859 OR 0003-9888 OR 1359-2998 OR 1072-4710 OR 1040-8703 OR 1940-5510 OR 0012-1622 OR 1018-8827 OR 1747-7166 OR 0890-8567 OR 1044-5463 OR 0022-3476 OR 1661-7800 OR 1526-0542 OR 0905-6157 OR 1155-5645 OR 1545-5009 OR 1529-7535 OR 0891-3668 OR 0931-041X OR 8755-6863 OR 0031-3998 OR 0031-4005 OR 1744-165X OR 1055-8586 OR 0146-0005 OR 1550-7416 OR 0169-409X OR 0006-2952 OR 0306-5251 OR 0007-1188 OR 0312-5963 OR 0009-9236 OR 1871-5273 OR 1755-5930 OR 1389-2002 OR 1389-4501 OR 1367-6733 OR 1472-4472 OR 1471-4892 OR 1359-6446 OR 0090-9556 OR 0360-2532 OR 1368-7646 OR 0939-6411 OR 1742-5247 OR 1354-3784 OR 1472-8222 OR 1178-2013 OR 0378-5173 OR 0167-6997 OR 0168-3659 OR 1557-1890 OR 0022-3565 OR 1543-8384 OR 0026-895X OR 1474-1776 OR 0028-3908 OR 0724-8741 OR 1462-2416 OR 1470-269X OR 1043-6618 OR 0031-6997 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OR 0033-2909 OR 0887-0446 OR 1047-840X OR 1082-989X OR 0033-295X OR 0956-7976 OR 1089-2680 OR 0278-2626 OR 0010-0277 OR 0010-0285 OR 8756-5641 OR 1363-755X OR 1528-3542 OR 0898-929X OR 0096-3445 OR 0096-1523 OR 0278-7393 OR 1748-6645 OR 0028-3932 OR 0079-7421 OR 0048-5772 OR 1749-5016 OR 1364-6613 OR 0195-6108 OR 0361-803X OR 1941-9651 OR 0363-9762 OR 1619-7070 OR 0938-7994 OR 1065-9471 OR 0360-3016 OR 0020-9996 OR 1097-6647 OR 0161-5505 OR 1936-878X OR 0740-3194 OR 0094-2405 OR 1535-3508 OR 1536-1632 OR 0033-8419 OR 0167-8140 OR 0001-2998 OR 1053-4296 OR 0179-7158 OR 0736-9387 OR 0003-9993 OR 0269-2155 OR 0963-8288 OR 1973-9087 OR 1088-3576 OR 1534-4320 OR 0885-9701 OR 1743-0003 OR 0190-6011 OR 1836-9553 OR 1650-1977 OR 1356-689X OR 1545-9683 OR 0803-9828 OR 0031-9023 OR 0090-5550 OR 0941-4355 OR 1040-0605 OR 1044-1549 OR 1073-449X OR 0003-4975 OR 0903-1936 OR 0022-5223 OR 1556-0864 OR 0169-5002 OR 1465-993X OR 0040-6376 OR 0006-3363 OR 0268-1161 OR 1360-9947 OR 1470-1626 OR 0003-4967 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OR 0004-0010 OR 1471-2393 OR 0007-1323 OR 0012-3706 OR 0748-7983 OR 0013-726X OR 1010-7940 OR 1078-5884 OR 1072-7515 OR 1526-6028 OR 1091-255X OR 0022-3050 OR 0022-3085 OR 0022-4790 OR 0741-5214 OR 0268-8921 OR 0196-8092 OR 1092-0684 OR 0148-396X OR 0960-8923 OR 0032-1052 OR 1085-5629 OR 1073-2322 OR 0930-2794 OR 1550-7289 OR 0039-6060 OR 0934-0874 OR 0041-1337 OR 0362-1642 OR 0340-5761 OR 1040-8444 OR 1568-7864 OR 0012-6667 OR 0893-6692 OR 1860-8965 OR 1059-0501 OR 1093-7404 OR 0267-8357 OR 0027-5107 OR 1383-5742 OR 1743-5390 OR 1743-8977 OR 0179-5953 OR 0041-008X OR 1096-6080 OR 0300-483X OR 1600-6135 OR 1083-8791 OR 0963-6897 OR 1053-2498 OR 1527-6465 OR 1547-3287 OR 0001-706X OR 0002-9637 OR 1475-2875 OR 1935-2735 OR 1360-2276 OR 0272-6386 OR 1931-857X OR 1464-4096 OR 1555-9041 OR 1062-4821 OR 0302-2838 OR 1046-6673 OR 1743-6095 OR 0022-5347 OR 0085-2538 OR 1759-5061 OR 1759-4812 OR 0931-0509 OR 0270-4137 OR 0270-9295 OR 1078-1439 OR 0724-4983 OR 0895-7061 OR 0969-6970 OR 1079-5642 OR 0021-9150 OR 1567-5688 OR 1522-6417 OR 0957-9672 OR 0194-911X OR 0263-6352 OR 1538-7933 OR 0094-6176 OR 0039-2499 OR 0340-6245 OR 0166-3542 OR 1438-4221 OR 0022-538X OR 1742-4690 OR 1052-9276 OR 0007-0998 OR 0009-3920 OR 0361-476X OR 1040-726X OR 0046-1520 OR 0022-0167 OR 0022-0663 OR 0022-4405 OR 0034-0553 OR 0279-6015)) AND groni*[Affiliation]; +130 new citations

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Tensions and approaches within the context of a failed EHR implementation program

Inleiding
Het elektronisch patiënten dossier (EPD) is een belangrijk instrument binnen de gezondheidszorg, ook het UMCG werkt aan een EPD. Ondanks de stijgende populariteit, falen dergelijke projecten nog altijd met gemiddeld 70%. Binnen elke verandering, is er sprake van spanningen en hoe betrokkenen daar mee om gaan. Dit onderzoek kijkt naar welke polen dominant zijn binnen ‘wat’ en ‘hoe’ spanningen, in de context van een gefaald EPD-implementatie programma en hoe de betrokkenen deze spanningen benaderden. Dit leidde tot de vraag: ‘Wat zijn de dominante polen binnen de ‘wat’ en ‘hoe’ spanningen en hoe benaderen betrokkenen deze spanningen op departementaal niveau in de context van een gefaald EPD implementatie programma?’

Methode
Kwalitatief onderzoek via interviews op vier verschillende afdelingen van het UMCG. De respondenten hadden verschillende functies binnen de afdeling, bijvoorbeeld dokter, verpleegkundige of manager. Analyse van de interviews op basis van een analyse binnen de afdelingen en een analyse tussen de afdelingen.

Resultaten
Er zijn drie dominante polen zijn: een gestandaardiseerd systeem, een grote omvang en een top-down initiatief. De spanning stapsgewijs versus big bang kent geen dominante pool. Daarnaast zijn de twee meest gebruikte benaderingen selectie en separatie. Dit betekent dat elke spanning is erkend door de respondenten en dat of de respondent de ene pool verkoos boven de andere pool of dat er onderscheidt werd gemaakt op verschillende niveaus. Als laatste zijn er vier sub-spanningen ontwikkeld; (1) delen versus aanpassen van informatie, (2) samenwerken versus individueel aanschaffen van een EPD, (3) ontwikkel eigen EPD versus een bestaand product kopen en (4) segmenteer op basis van afdelingen versus professie.

Conclusie
De conclusie van het onderzoek is dat er drie dominante polen zijn; een gestandaardiseerd systeem, een grote omvang en een top-down initiatief. Daarbij zijn er twee benaderingen het meeste gebruikt; selectie en separatie. Beperkingen tijdens dit onderzoek waren dat de interviews door meerdere interviewers zijn gehouden, wat kon leiden tot discrepantie in de gestelde vragen. Daarnaast zijn beide polen genoemd in de vraagstelling rondom de spanningen, met de consequentie dat beide polen veelal werden erkend en de benadering selectie het vaakst werd gebruikt. Implicaties voor verder onderzoek is om het te generaliseren door middel van spanningen onderzoeken in andere zorginstellingen. Daarnaast zou het interessant zijn om meer te focussen op de bandering van de respondent ten opzichte van de spanning, om de relatie tussen beiden te verstevigen. Als laatste, het blijven volgen van dit longitudinale onderzoek biedt kansen om spanningen te volgen rondom het implementeren van een EPD, die relevant zijn voor de mate van succes.

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