Annual Report 2008
Julius Center for Health Sciences and Primary Care
Annual Report 2008Julius Center for Health Sciences and Primary Care
UMC Utrecht
The Julius Center for Health Sciences and Primary Care is one of the twelve divisions of the
University Medical Center Utrecht (UMC Utrecht). It carries out scientific research, provides
education and offers expertise and facilities in the clinical health sciences field.
The Center aims to have a leading and acquisitive role in the enlargement and dissemination of
knowledge, particularly in the field of health sciences. This is done by carrying out groundbreaking
research on four disease-related themes and research methodology, by offering courses for (bio)
medical students, researchers and clinicians, and by providing academic primary care.
Disciplines represented in the Center are general practice, (clinical) epidemiology, nursing science,
medical technology assessment, public health, medical ethics, nutritional sciences and biostatistics.
In this annual report the reader will find information on activities, output and finances in 2008.
Contact information:
M. Donkervoort, PhD
Policy officer, research strategy
Julius Center for Health Sciences and Primary Care
University Medical Center Utrecht
Visitors: Heidelberglaan 100, Utrecht, The Netherlands
Correspondence: Str.6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
URL: www.juliuscenter.nl
E-mail: [email protected]
3
Contents Introduction 7
Organization 15
Brief History 17
Organizational Structure 17
Research 19
Research Organization 21
Research Themes 32
Collaboration and Affiliations 43
Research Highlights 48
Education 51
Educational Organization 53
General Practice 57
Epidemiology 64
Public Health 74
Biostatistics 77
Medical Humanities 80
Nursing Science 82
Nutritional Science 85
International Activities in Education 87
Patient Care 91
Nutritional Sciences and Dietetics 93
Julius Center Health Care Leidsche Rijn 99
Unit Health Care Innovations 101
4 Annual Report 2008
Operational Support 105
Management Support 107
From CTSU to Julius Clinical Research and Research Support 108
Personnel and Finances 119
Personnel, Figures 121
Personnel, Listing 122
Financial Report 132
Research Projects 2008 137
Cardiovascular Diseases 139
Infectious Diseases 149
Cancer 154
Mental Health 157
Theoretical Epidemiology and Biostatistics 161
Miscellaneous 166
Clinical Trial Services Unit / Research Services 170
Data Management 174
Publications 2008 179
PhD Theses 181
International Refereed Publications 183
Professional Publications 212
Books and Book Chapters 216
Nederlandse Samenvatting 221
5
Introduction
‘Being selected as an AsiaLink PhD fellow is the best
thing that ever happened in my career and I am
looking forward to making it a success!’
Nirmala Bhoo Pathy,
PhD fellow AsiaLink Programme
Introduction 9
The Julius Center for Health Sciences and Primary Care has a simple
strategy. It endeavors to do everything necessary in order to excel within
research and teaching in health sciences. While sometimes our achieve-
ments in research may seem to dominate our profile, we are firmly con-
vinced that the fundament on which to build our scientific and health
care achievements is high-quality teaching. Teaching medical students
about primary care, public health and the principles and methods of
patient-oriented research; teaching MSc and PhD fellows how to set up
and conduct research projects that have relevance and impact; teaching
general practitioners the way to take best care of their patients and set
new standards for primary care. Our teaching tries to bring out the best
in our students by stimulating the development of their curiosity and
talents to learn and to achieve. As William J. Mayo said ‘One of the chief
defects in our plan of education is that we give too much attention to
developing the memory and too little to developing the mind’.
We aim to develop the critical minds required by modern health care
and clinical research. The present annual report aims to underline the
value we place on teaching by showing you some faces and views of
those who are at the ‘receiving end’. This involves our students, pupils
and fellows from the Netherlands and abroad, with a background in
medicine and other disciplines. We are privileged to be able to teach this
vibrant and ever changing community and are eager to simultaneously
benefit from what they are able to teach us.
During 2008, our organization underwent several changes that resulted
from a reflection on our strategies and organizational insights developed
over the previous years. Our line-organization was strengthened and
increased and responsibility was given to the coordinators of our five
research themes for defining their strategy and budgetary priorities. For
several years it has been clear that the success of our clinical trials and
10 Annual Report 2008
the dedicated organization built for it would eventually require a reposi-
tioning of these activities relative to the other tasks of the Julius Center.
On the one hand, growth and, sometimes, hectic negotiations and busi-
ness development called for a larger degree of independence and less
interference with other priorities in the Center. On the other hand, it
was important to maintain the scientific stimulus and output from
major, randomized trials and access to its infrastructural resources. After
careful consideration, the Management of the Julius Center and the
Board of the University Medical Center Utrecht decided to transfer the
clinical trial activities to an independent Academic Clinical Research
Organization; Julius Clinical Research BV. The links between the Julius
Center and Julius Clinical Research BV remain close and the UMC
Utrecht is the majority shareholder in the new company. We believe that
this is the best way to move forward and to stay at the forefront of inter-
national clinical trials while also maintaining the fruitful interaction
between the trials and other scientific work in the Center.
The merger of the former University Center for Biostatistics in the Julius
Center also took place in 2008. This reflected the emerging view that
Biostatistics in Utrecht needs a more solid scientific foundation and aca-
demic home base while maintaining high quality consultation and
teaching, not only within the UMC Utrecht but also for other faculties
and departments at Utrecht University. To further accentuate the scien-
tific ambitions in the domain of biostatistics, a Chair of Biostatistics has
been established at the Julius Center for which candidates are currently
being sought. As Biostatistics enters the Julius Center, we see the depart-
ment of Nursing Science depart. Major changes in the financing of
Nursing Sciences’ educational activities made a reorganization inevitable
and it was judged that scientific research by the discipline would benefit
Introduction 11
from a decentralized position within clinical divisions of the UMC
Utrecht that have material patient care delivered by nurses.
Successes in education and research were continued throughout 2008.
A record number of students graduated from the general practice voca-
tional training and from the Master of Science program in
Epidemiology. The latter program is being organized in conjunction
with other UU epidemiologic groups and was positively evaluated in
2008 by the Accreditation Organization of the Netherlands and Flanders.
This guarantees the registration of the MSc exam by law and full com-
pliance with quality control standards. Also, in terms of numbers of
completed PhD theses, the Julius Center set a new record which will be
difficult to beat in the coming years. No less than 39 fellows defended
their PhD thesis with a staff member from the Julius center as (co-)
supervisor or co-promoter. For the fourth time, the Julius Center’s chair,
Rick Grobbee, became ‘PhD Supervisor of the Year’, passing a total of
over 100 PhD fellows whom he has guided successfully towards their
theses defense. Professor Yolanda van der Graaf occupied an honorable
third position among the University’s top supervisors in 2008.
This year, in terms of simple numbers, staff members from the Julius
Center were involved in 400 international scientific publications, 10 of
which were in journals with an impact factor above 20; five appeared in
the Lancet, four were in the New England Journal of Medicine and one
was in the Journal of the American Medical Association (JAMA).
Two important prizes, awarded in 2008, emphasized the Julius Center’s
scientific position. Professor Bert Brunekreef, jointly appointed by the
Julius Center and the Institute for Risk Assessment Sciences, Faculty of
Veterinary Medicine, received the prestigious Heineken Prize for
groundbreaking research in occupational epidemiology. The scientific
contributions to clinical epidemiology by Professor Rick Grobbee were
12 Annual Report 2008
recognized with the award of the bi-annual Catharijne Prize and Julius
Center’s Dr Maroeska Rovers was awarded the Elisabeth von Freyburg
medal for most promising young scientist. While listing the successes of
individual staff members, the competitive appointment of Dr Yvonne
van der Schouw as Professor of Chronic Disease Epidemiology, as part
of the UMC Utrecht strategic chairs program, should also be mentioned.
The increased efforts of the Julius Center to further improve the quality
of its (inter)national teaching activities are exemplified by the publica-
tion of the textbook ‘Clinical epidemiology. Principles, methods and
applications for clinical research’, in 2008. This book was written by Rick
Grobbee and Arno Hoes and includes contributions by many other staff
members from the Center.
While the Julius Center values its position in the University Medical
Center Utrecht, we are also very conscious of the international nature of
our teaching and research. Our emphasis on strong and productive
international relations was expressed in 2008 by the establishment of
two visiting chairs in Cardiovascular Disease Epidemiology. Dr Stephen
MacMahon, from the George Institute for International Health, Sydney,
Australia, and Dr Dan Levy, Director Framingham Heart Study,
Framingham and Boston University, US, were appointed to take up these
positions. Both have been appointed for a period of four years and, dur-
ing this time, they will regularly visit the Netherlands, provide teaching
and stimulate collaborative projects. Finally, as recommended by the
board of supervisors of the ‘Prince Claus Chair in Development and
Equity’, Utrecht University has appointed Professor Irene Agyepong as
holder of the Chair until August 2010. The Julius Center is pleased to
host the Prince Claus Chair for this period and looks forward to collabo-
ration with Professor Agyepong to promote health scientific research
and evidence based medicine in Ghana.
Introduction 13
It is customary to highlight academic achievements when introducing
the annual report of an academic department such as the Julius Center.
However, an important factor in the achievement of any successes is the
contribution and dedication by the people in all layers of the organiza-
tion. First and foremost, the Julius Center wants to be an inspiring and
fun place to be. We promote the expression of talent and determination
by our staff within the Center as much as outside of it. Perhaps the best
example of this attitude is provided by Chantal Boonakker who com-
bines 20 hours of training with 20 hours of PhD work at the Julius
Center and who won a bronze medal for her performance at the 2008
Paralympic Games in Beijing. All of us have gifts and competences and,
together, they make our Center what it is today. We set our academic
standards high and focus on individual results but always remain aware
of the value of being part of the larger community of the Julius, of the
University Medical Center Utrecht at large and our responsibilities
towards science and healthcare in the Netherlands and abroad.
The management team of the Julius Center for Health Sciences and
Primary Care
Yolanda van der Graaf, manager education
Diederick E. Grobbee, chair, medical manager
Arno W. Hoes, manager research
Anne-Marie Laeven, manager business administration
14 Annual Report 2008
Introduction 15
Organization
‘The ratio of We’s to I’s is the best indicator
of the development of a team’
Jaap Trappenburg, PhD fellow and active member
of Julius staff association
Organization 17
Brief History
The Julius Center was established on 16 December 1996. It was founded
on the basis of the previous departments of epidemiology and public
health and on the clinical epidemiology’s hospital unit. It was originally
called the Julius Center for Patient Oriented Research. Since then, both
its scope and size have markedly increased and this is reflected by the
number of disciplines represented within the Julius Center. In 1999 the
department of General Practice merged with the department of patient-
oriented research to become the Julius Center for Patient-Oriented
Research and General Practice. In 2002, the department of Nursing
Science and the Nutritional Sciences group joined the Center to become
the current ‘Julius Center for Health Sciences and Primary Care’. In 2008,
Biostatistics was added to the center, by integrating the former Center
for Biostatistics, to reinforce education and research in this area.
Changes in educational financing led to a reorganization of nursing
sciences and, as a result, the discipline left the Julius Center at the end of
2008, to be re-allocated at several clinical divisions of the UMC Utrecht.
In response to the increasing challenges facing clinical research in the
21st century, the clinical trial unit was incorporated into a private com-
pany, Julius Clinical Research, which is dedicated to the performance of
large-scale trials.
Organizational Structure
The organizational structure can be found inside the cover.
Organization 19
Research
‘Research is like a triathlon; a challenging race with
variation requiring perseverance and commitment’
Margriet de Beus, PhD fellow Julius Center
Research 21
Research organization
The University Medical Center Utrecht has formulated seven main
research themes. These fit into a matrix with four disease-related themes
on the horizontal and three methodological themes on the vertical axes.
The Julius Center’s main contribution to the UMC Utrecht’s total body
of research is through the research theme ‘Epidemiology’. With rare
exceptions, all of the Center’s research activities can be classified as ‘clini-
cal epidemiological’ research, i.e. etiologic, diagnostic, prognostic and
intervention research with relevance for patient care. Building upon this,
the Julius Center contributes to all four disease-related areas of research:
cardiovascular disease, infection & immunity, cancer, and mental health.
In addition, there are strong links with the UMC Utrecht’s other two
methodological research themes: ‘Imaging sciences’ and ‘Genetics’.
The Julius Center’s research activities focus on five research themes, i.e.
the same four disease-related areas as the UMC Utrecht (cardiovascular
disease, infection & immunity, cancer, and mental health) and one
methodological theme (Theoretical Epidemiology & Biostatistics).
Within these themes, there is further focus on subfields, such as research
on (etiology and prognosis of) diabetes mellitus as part of the cardiovas-
cular disease theme or on the effects of vaccinations within the infection
& immunity theme.
All five research themes are headed by one research coordinator or two
for the largest theme, cardiovascular diseases. Importantly, the research
activities of the (clinical or methodological) disciplines represented in
the Julius Center (Clinical Epidemiology, General Practice/Primary
Care, Public Health, Biostatistics, Medical Technology Assessment,
Medical Ethics, Nutritional Sciences and Nursing Sciences) are also
incorporated within these five research themes and not separately.
22 Annual Report 2008
Themes
Dis
cip
lines
CardiovascularDiseases
InfectiousDiseases
Cancer
MentalHealth
TheoreticalEpidemiology
and Biostatistics
Cli
nic
al
Ep
idem
iolo
gy (
CE)
Gen
era
l Pra
ctic
e (
GP)
Pu
bli
c H
ealt
h/M
TA/
Eth
ics
(PH
/MTA
)
Nu
trit
ion
al
Sci
en
ces
(Die
teti
cs, D
T)
Bio
stati
stic
s
Nu
rsin
g
Sci
en
ce (
NS)
The research methods for all of these disciplines can be broadly charac-
terized as (clinical) epidemiological and this was one of the main rea-
sons for these disciplines being combined within the Julius Center. The
research activities can, thus, be represented by a matrix structure, in
which the horizontal axis comprises the five research themes and the
disciplines are depicted in the vertical axis. The Center’s policy is to con-
centrate its research as much as possible on the matrix’s overlapping
areas so that each of its disciplines benefit most from the Center’s scien-
tific and clinical expertise and the UMC Utrecht’s scientific themes as a
whole are strengthened.
The Julius Center has a formalized link with the interfacultary Institute
for Risk Assessment Sciences (IRAS), environmental and occupational
Research 23
epidemiology at UU. This has been embodied by the joint appointment
of Prof Bert Brunekreef and honorary appointee Prof Dick Heederik.
There is also collaboration with other epidemiological research groups
at Utrecht University, in particular with the Pharmaco-epidemiology
group (from the Utrecht Institute for Pharmaceutical sciences) and
Veterinary Epidemiology groups. Moreover, collaborations were recently
strengthened with health/scientific institutions in the vicinity of the
University Medical Center, such as the National Institute for Public
Health and the Environment (in Dutch: RIVM) and the Municipal
Health Authority (in Dutch: GGD) in Utrecht.
In addition to the acquisition and conduct of its own research projects,
either independently as an institute or in collaboration with other
research groups, a major responsibility of the Center is to provide meth-
odological advice and to support clinical research in virtually all of the
University Medical Center’s departments. Staff members act as consul-
tants for research methods on a range of clinical investigations both
within and outside the UMC Utrecht. The Center also plays a pivotal
and formal role in the quality assurance of randomized trials performed
in the UMC Utrecht. These are important and expanding activities for
the Julius Center. For many clinical departments, the intense and contin-
uous interaction with epidemiology has resulted in joint staff appoint-
ments, including the departments of anesthesiology, cardiology, cardio-
thoracic surgery, dermatology, internal medicine, neurology, pediatrics,
psychiatry, and radiology.
CohortsThe Julius Center coordinates and participates in several large research
cohorts. These cohorts are an important base for research and provide
ample opportunities for obtaining financial research support. Moreover,
the projects of the GP-network Utrecht and the Utrecht Health Project are
intended to create an infrastructure in which research questions on efficacy
and effectiveness of health care and effects of (local) health care policy can
be answered. The latter is of major importance for increasing the expertise
in the areas of health care improvement, extramural health care and gener-
al practice.
The major cohorts are:
ADDITION
The ADDITION (Anglo-Danish-Dutch study of Intensive Treatment In peOple
with screeN-detected diabetes in primary care)-Netherlands cohort consists
of 498 patients with screen-detected type 2 diabetes mellitus, diagnosed in
2002-2004 during a population screening among 57,000 people in the
south-western part of the Netherlands. The initial purpose of the study is to
investigate the effects of a multifactorial, intensified treatment on cardio-
vascular mortality and morbidity in a randomized design. After finishing
the trial in 2009, the cohort will be followed up with an investigation into
different aspects of the ‘diabetes career’ of screen-detected diabetes
patients.
24 Annual Report 2008
AGIS Health database
The AGIS Health Database is a registry of a health insurance company and
contains all health care procedures carried out in the last ten years involv-
ing 1.2 million health insured persons. Data is preserved on health care pro-
cedures by all contracted health care providers such as general practitio-
ners, specialists, physiotherapists, pharmacists, midwives and hospitals.
Besides data on health care procedures in primary (consultations, referrals,
prescriptions) and secondary care (consultations, prescriptions and
Diagnostic-Treatment Codes), a number of personal characteristics are doc-
umented, such as date of birth and gender. The insured persons are repre-
sentative of the Dutch population. Data from this large cohort offers
opportunities for all kinds of epidemiological research, but the main pur-
pose is to improve knowledge on health care consumption and interaction
between primary care, secondary care and public health. Data is also avail-
able to support health care management strategies and to evaluate
improvements in quality of care.
ARYA
The Atherosclerosis Risk in Young Adults (ARYA) study is an unselected birth
cohort of 750 persons born between 1970 and 1973 in and around the city
of Utrecht. Its research focus is on early life determinants of later life car-
diovascular disease. At birth, participants had elaborate birth data regis-
tered at the Municipal Health Service in Utrecht and they were followed up
into young adulthood. In 1999, participants underwent elaborate cardio-
vascular disease risk profiling, including classical cardiovascular disease risk
factors as well as elaborate non-invasive arterial wall measurements.
Research 25
DOM
The DOM cohort (Doorlopend Onderzoek Morbiditeit en Mortaliteit =
Ongoing Study on Morbidity and Mortality = Diagnostisch Onderzoek
Mammacarcinoom) is a cohort of 50,000 healthy women, living in Utrecht
and surroundings. They were recruited from among breast cancer screening
participants, aged between 40 and 70 years when recruited between 1974-
1986. The purpose of the DOM study is to identify risk factors for several
chronic diseases, especially (breast) cancer.
Baseline measurements included a short medical examination and extensive
lifestyle and medical questionnaires. Overnight urine samples were collect-
ed and stored at -20°C.
Electronic patient records communication disorders
All children referred to our tertiary care centre for multidisciplinary evalua-
tion of speech and language problems undergo a structured evaluation by
an otolaryngologist, audiologist, speech therapist and a child psychologist.
All data is then fed into their electronic patient records. Currently, about
500 children are included.
EPIC-NL
EPIC-NL is the Dutch contribution to European Prospective Investigation
into Cancer and Nutrition (EPIC). EPIC-NL (www.epic.eu) is a merger of the
Prospect-EPIC cohort (coordinated by the Julius Center) and the MORGEN-
EPIC cohort (coordinated by the National Institute of Public Health and the
Environment (RIVM), Bilthoven). It is a cohort of over 40,000 men and
women from Amsterdam, Doetinchem, Maastricht and Utrecht and sur-
roundings, aged 20-70 years at recruitment in 1993-1997. The purpose of
this study is to assess the relationship between nutrition and cancer and
other chronic diseases. Participants filled out lifestyle and medical question-
26 Annual Report 2008
naires and extensive food frequency questionnaires. Blood samples were
taken, fractionated and stored at -196°C for all participants.
HNU
The HNU (Huisartsen Netwerk Utrecht = Utrecht General Practice Network)
was founded in 1989 and is a collaboration between the General Practice
department of the Julius Center and around 38 general practitioners work-
ing in six primary health care centers in the Utrecht area. Approximately
60,000 patients are enlisted with these centers. Data on all primary care
consultations (including the ICPC coded diagnosis), ATC-coded prescriptions
and referrals of these patients have been encoded in the database since
1992. GPs receive ongoing training in ICPC coding to ensure high quality
coding. The primary goal was to set up a network of general practices that
could provide valid and detailed routine care data on a primary care cohort
for observational studies. Nowadays, the HNU has a large, centralized data-
base containing observational data on the patients enlisted from 1995 up
until 2007.
IJSCO
The IJSCO (IJsselstein Screening for Central Obesity to detect metabolic syn-
drome) cohort consists of 473 people with screen-detected metabolic syn-
drome (MetS). The screening among approximately 12,000 inhabitants of
IJsselstein, 20-70 years old on July 1st, 2006 and not known to have cardio-
vascular risk factors, started with self-measurement of waist circumference
using a mailed tape measure. People with screen-detected MetS were
advised to visit their general practitioner. Approximately half a year after
the screening, they were followed by means of data collection from GP’s
medical records to investigate the normal course of events following
screening for MetS. After approximately three years, all patients will be
measured again.
Research 27
Netherlands Amniotic Fluid (NAF) cohort
The Netherlands Amniotic Fluid (NAF) cohort is an ongoing birth cohort
focusing on the role of amniotic fluid inflammation in relation to respirato-
ry tract infections during the first years of life. Healthy term infants are
studied for the NAF study. Data collected at birth comprises: obstetric histo-
ry, amniotic fluid cytokine measurements, Toll-like receptor responses,
genetic polymorphisms and neonatal lung function. During follow-ups,
daily respiratory symptoms are noted in a parental log and nasal swabs are
taken for virology testing during each respiratory episode during the first
year of life. The parents are instructed to take the diary to the general
practitioner, who is subsequently asked to report the ICPC diagnosis.
Currently, about 500 infants are included.
PCR-MN
PCR-MN (Psychiatric Case Registry Midden Nederland) is an anonymous psy-
chiatric case registry that contains information on all patients who have
been treated in one of the mental health care institutions in the central
region of the Netherlands. It is one of the four regional psychiatric regis-
tries that are supported by the Ministry of Health. The primary aim of the
database is to provide and analyze epidemiological data on mental health
care, to provide management support and to improve quality of care. All
major institutions for mental health care in the central region of the
Netherlands participate in the registry. From 1999 onwards, data (patient
characteristics, DSM IV diagnosis, referring centre, type of care) for approxi-
mately 120,000 patients with over 380,000 diagnostic codes, who were
treated for mental health problems, has been included in the database.
28 Annual Report 2008
PIAMA
The PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth
cohort includes circa 4,000 children who have been followed for 8 years
since birth. It is a multi-centre study including IRAS/Julius Center, National
Institute of Public Health and the Environment (RIVM), Erasmus University
Medical Center Rotterdam, University Medical Center Groningen and
Sanquin/CLB Amsterdam. The study was started in 1996 and its purpose is
to investigate the occurrence of asthma and allergy in young children, as
well as lifestyle and environmental risk factors for these diseases. At several
points in time, data was collected on exposure and health status. Blood
samples were collected in a sub sample of the children.
PREDICT
This is a prospective study in which consecutive general practice attendees
in six European countries are recruited and followed up after six and twelve
months for the prevalence of depression. The Dutch part is coordinated by
the Julius Center. Its purpose is to develop a risk score for use by general
practitioners to predict the onset and maintenance of depression.
Recruitment was started in 2003 and participants were 18-75 years old.
Over 10,000 participants were included, of which over 1,000 participants
were in the Netherlands.
PROVIDI
PROVIDI is a cohort of ca. 16,000 patients who have undergone a chest
multislice Computed Tomography (msCT) scan for diagnostic reasons. The
purpose of the cohort is to investigate the extent to which unrequested
imaging findings are of prognostic relevance for the occurrence of several
relevant diseases, other than the diagnostic that the CT was originally indi-
cated for.
Research 29
SMART
The SMART (Second Manifestations of ARTerial diseases) cohort started in
1996. It is an ongoing, prospective, single-center cohort study of patients
with cardiovascular risk factors or clinically manifest arterial disease. The
purpose is to screen these patients for vascular problems elsewhere in the
body. Consecutive patients aged 18 to 80 years, referred to the University
Medical Center Utrecht (UMCU), with manifest arterial disease or a cardio-
vascular risk factor underwent vascular screening including a questionnaire,
blood chemistry, and ultrasonography. After this screening, all patients fill
out a biannual questionnaire in order to collect information on cardiovas-
cular morbidity and mortality as well as diabetes mellitus end-points.
SMART includes over 8,200 patients with more than 10 years of follow-up.
In 2008, SMART-2 screening commenced. All patients screened in the past
have been approached again to take part in this second screening. The aim
of this second vascular screening is to study the course of atherosclerosis
and vascular risk factors in time and evaluate the impact of a possible earli-
er treatment. In 2008, more than 200 patients had been screened, accord-
ing to this SMART-2 protocol.
Utrecht Health Project (LRGP)
The Utrecht Health Project (or Leidsche Rijn GezondheidsProject (LRGP) is a
population study of residents of the Leidsche Rijn, Utrecht area, who have
been invited through their GPs working in the academic Primary Healthcare
Centers in the area. The purpose of this study is to enable research on the
impact of changes in health care policy, developments in community and
public health and determinants - e.g. life style, behavioral, biological and
genetic - of health and disease during lifetime, as well as quality manage-
ment of (primary) health care itself. Until now 10,000 (of 25,000) inhabit-
ants have given informed consent, Individual Health Profiles (IGP) have
been mad, and blood samples, ECG and spirometry data has been collected
30 Annual Report 2008
at recruitment. Follow-up data (on average 5 years now) is collected
through continuous linkage with the computerized medical files recorded
by trained general practitioners. Data on diagnoses, prescriptions and refer-
rals of all 25,000 inhabitants is encoded in the database and coupled with
intake IGP data of those having given informed consent.
Whistler
Whistler (Wheezing Illnesses Study in LEidsche Rijn) is a satellite cohort of
the Utrecht Health Project. Participants are newborns to inhabitants of
Leidsche Rijn. Whistler was originally initiated to study early life predictors
of (lower tract) respiratory disease in childhood. The focus has now expand-
ed to include cardiovascular disease research questions as well. Recently,
the milestone of 2,000 included newborns was reached in Whistler. The ulti-
mate purpose is to follow participants up until adulthood.
Extensive descriptions of cohorts and related websites can be found at:
http://www.juliuscentrum.nl/julius/Research/cohorts/
Research 31
32 Annual Report 2008
Research Themes
Cardiovascular Diseases
The Cardiovascular Diseases research line is one of the four disease-
based research lines at the Julius Center, which coincides with the UMC
defined, disease-based field of interest; Cardiovascular Disease. It is the
Julius Center’s largest research line. The research within this line uses
approaches that include the full range of epidemiological research meth-
ods, such as multi-centered randomized controlled trials to study the
effects of preventive and therapeutic interventions and cohort, case-
control and cross-sectional studies. The research focuses on the causes,
diagnosis, prognosis and therapy of common cardiovascular diseases.
Cardiovascular research line is centered around several following themes
with dedicated staff.
1 Early origins of vascular disease. Within this theme a research
programme started in 2008 entitled ‘From biomarker discovery to
primary prevention in early life: an UMC Utrecht joint action for the
prevention of cardiovascular disease’. In this project, highly
specialized cardiovascular knowledge is made accessible for primary
prevention. In cohorts of children and patients with varying degrees
of atherosclerosis markers, of inflammation, fat metabolism,
coagulation and immunologic parameters will be measured. The
purpose is to stratify people at a young age into high and low risk
individual using these measures. The project is coordinated by the
Julius Center and conducted in collaboration with the divisions
Pediatrics, Heart & Lungs, Internal Medicine & Dermatology,
Neurosciences, and Women & Baby.
2 Endocrinology of vascular disease. Within this theme, in 2008 Dr.
Yvonne van der Schouw was appointed Professor of Chronic Disease
Epidemiology. This will boost the further development of this
research theme to determine the role of menopause (cause or effect)
in relation to development of atherosclerosis and cardiovascular
disease risk. Furthermore, an important trial on the supplementation
of testosterone was published in JAMA in 2008.
3 International intervention studies. In 2008 several trials ended with
publications in New England Journal of Medicine; one on the
relation of tibolone treatment and fracture rate in postmenopausal
woman (LIFT) and one on the effect of blood pressure and glucose
lowering on vascular risk in patients with type II diabetes
(ADVANCE). Furthermore, a multicenter international polypill trial
started in 2008 in asymptomatic high risk subjects using a network of
international collaborators.
4 Diagnosis and prognosis of vascular disease in primary care. The
general practitioner is the gatekeeper within the Dutch health care
system. It is of utmost importance, but also sometimes extremely
difficult, to arrive at appropriate diagnoses in primary care in order
to further improve patient management. Diagnostic studies in
primary care are, therefore, an important research topic at the Julius
Center, also in the cardiovascular research line. In 2008, the AMUSE
(Amsterdam Maastricht Utrecht Study on thromboEmbolism) study
was finalized. The AMUSE study, evaluated the safety and efficiency
of using a clinical decision rule including a point-of-care d-dimer
assay in patients suspected of deep vein thrombosis of the leg. The
study showed that a diagnostic management strategy in primary care
by using a simple clinical decision rule and a point-of-care d-dimer
Research 33
34 Annual Report 2008
assay reduces the need for referral to secondary care of patients with
clinically suspected DVT by almost 50% and is associated with an
acceptably low risk for subsequent venous thromboembolic events.
The diagnostic prediction rule has been incorporated into the
guideline on deep vein thrombosis for general practitioners in The
Netherlands. Similar diagnostic studies are ongoing in patients
suspected of myocardial infarction/acute coronary syndrome and
pulmonary embolism.
5 Vascular complications of type 2 diabetes mellitus in primary care.
In 2008, Julius Center investigators showed that it is possible to
reduce cardiovascular risk in patients with diabetes within 1 year
through intensive multifactor treatment. The study showing this was
picked up by ACP Journal Club of the American College of
Physicians – American Society of Internal Medicine, a medium to
help internists keep up to date by abstracting high quality research
from key journals of relevance to internal medicine. Care for type 2
diabetes patients is an important task for the general practitioner.
Another study showed that it is feasible, safe and effective to organize
care by delegating routine diabetes care to a practice nurse, combined
with computerized decision support and feedback. Funding was
obtained from the Netherlands Organization for Scientific Research
to start a study to assess whether reducing the number of visits for
diabetes patients from 4 to 2 per year has no adverse effects on
health.
6 Prediction of future vascular disease in secondary care. One of the
Julius Center’s cohorts is the Second Manifestations of ARTerial
disease (SMART) cohort. This unique cohort of patients at high risk
of cardiovascular disease (CVD) started in 1996. All patients referred
to the University Medical Center in Utrecht (UMC Utrecht) with
either a risk factor for CVD (hypertension, hyperlipidemia, diabetes)
or clinically manifest vascular disease (ischemic cerebral disease,
asymptomatic stenosis of the internal carotid artery, myocardial
infarction, angina pectoris, abdominal aortic aneurysm, intermittent
claudication) are eligible for inclusion in the study. Patients undergo
an extensive screening programme to detect asymptomatic
atherosclerotic lesions and to identify risk factors. Then, a
multidisciplinary team formulates an evidence-based treatment plan,
to reduce the patient’s risk of future cardiovascular events. This
treatment advice is sent to the patient’s general practitioner and to
his or her treating hospital specialist. Every 6 months patients are
asked to report, by mail, whether they have experienced or received
treatment for a vascular event in the last 6 months. In 2008, 5 PhD-
theses resulting from the SMART study were defended successfully.
One of these evaluated the SMART screening programme. For
patients who are not enrolled in a dedicated screening programme,
many risk factors are not systematically documented. Screening alone
is insufficient however for adequate treatment of these high-risk
patients and more intensive monitoring and follow-up is necessary.
Another thesis reported on the contribution of vascular diseases in
the development of brain atrophy and cognitive decline. In 2008, the
SMART-2 project started, in which patients enrolled in SMART are
screened for the second time. The main purpose of SMART-2 is to
study the course of atherosclerosis and risk factor development over
time, and to study effects of the treatment that was initiated on these
patients.
In 2008 research within the other themes (7) Diagnosis and Prognosis of
atherosclerosis, (8) Prevention of complication after cerebral vascular
Research 35
36 Annual Report 2008
disease in secondary care and (9) Epidemiology of haemophilia in sec-
ondary care was continued with considerable scientific output and suc-
cess in aquiring grants.
Infectious Diseases
Infectious diseases research at the Julius Center is centered around four
topics:
1 Prevention, diagnosis and prognosis of respiratory tract infections.
This research is mainly positioned within the primary care and Ear
Nose and Throat areas. An investigation, for example, may take place
into the extent to which certain patient characteristics predict an
abnormal and serious clinical progression of bronchial infections and
what the consequences for treatment and patient advice are. In
addition, antibiotic use and indications for prescribing in general
practice are being studied, as is the efficacy of prednisone treatment
in patients with persistent complaints of sinusitis. This research has
been expanded to include the development of asthma and allergy, in
relation to exposure to infectious agents and other environmental
determinants, both in young children and in occupationally exposed
subjects.
2 Efficacy (and cost-effectiveness) of vaccination strategies. In
collaboration with the department of Pediatric Immunology, the
National Vaccine Institute and pharmaceutical industries, an
increasing number of vaccination studies have been executed and are
ongoing. In addition to these studies, the role of confounding in
determining vaccination efficacy is also investigated. Currently, this
research group is heading the CAPITA study, in which 85,000 elderly
people will be randomized to an investigational 13-valent conjugate
pneumococcal vaccine or placebo to determine the efficacy of this
vaccine in preventing community-acquired pneumonia caused by
vaccine-specific pneumococcal serotypes.
3 Mathematical modeling of infectious diseases. In collaboration with
the Mathematical Institute of the University Utrecht and the National
Institute of Health and Environment, the dynamics (and prevention
of acquisition) of multi-resistant bacteria and influenza within
hospitals and the community at large is being investigated, as well as
potential effects of interventions. In 2008, intensified collaborations
between the National Institute of Health and Environment, the
Mathematical Institute, the Veterinary Faculty and the Julius Center
resulted in the creation of the Utrecht Center for Infectious Disease
Dynamics.
4 The effects of nosocomial infections and transmission of antibiotic-
resistant bacteria on patient outcome. The attributable mortality of
ventilator-associated pneumonia is investigated and the Julius Center
coordinates an international cluster-randomized trial in European
ICUs to determine the efficacy of several approaches to reduce the
transmission of antibiotic-resistant bacteria.
Cancer
Cancer research at the Julius Center has a strong focus on the etiology,
early diagnosis and screening of hormone dependant cancer, predomi-
nantly in women. Cancer is a serious health threat in the Netherlands,
with approximately 30,000 new cases a year in women. In 2008, for the
first time, more people died from cancer than from cardiovascular dis-
eases. However, the known causes of cancer barely explain 30% of all
cases encountered. An explanation for this rather low percentage may be
sought in the fact that environmental and hormonal factors are predom-
inantly studied without any consideration to genetic predisposition.
Cancer etiological research within the Julius Center strongly focuses on
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38 Annual Report 2008
the interaction between genes, hormones and lifestyle habits. For the
study of genetic determinants or gene-environmental interactions, the
Julius Center has access to biological material originating from two
large-scale on-going population-based cohorts, DOM and EPIC-NL,
which is a merger of the two Dutch cohorts participating in the
European Prospective Investigation into Cancer and Nutrition:
Prospect-EPIC and Morgen-EPIC.
For studies of the optimal (early) diagnostic and (clinical) follow-up
procedures in cancer patients, collaboration has been established with
clinicians from other departments of the University Medical Center in
Utrecht. Examples are the COBRA and MONET studies, both assessing
optimal diagnostic and therapeutic procedures in women with non-
palpable breast diseases. Studies to assess ‘quality of life’ in the daily care
of cancer patients also fall into the domain of the cancer research at the
Julius Center.
There is close cooperation with the Faculty of Medicine’s department of
epidemiology and public health at Imperial College in London, UK,
where the head of the cancer research line at the Julius Center, Petra
Peeters, has been appointed Professor for one day/week.
Mental Health
The Julius Center’s psychiatric epidemiology section studies psychiatric
disease and related co-morbidity in primary care and the population at
large. Mental illness represents a sizeable proportion of the global bur-
den of disease in the general population, but is only partly presented to
health care professionals. Major psychiatric disease represents 5% of the
prevalent morbidity in primary care, with an annual prevalence of 125
per 1000 patients. A substantial part of minor psychiatric morbidity is
presented in relation to somatic disease or functional syndromes or
expressed through excessive consultation frequency of unexplained
functional syndromes. Mental illness - though closely linked to somatic
ill-health – is traditionally studied in isolation. The psychiatric epidemi-
ology section focuses on the study of somatic - psychiatric comorbidity,
with the following themes:
1 The presentation of depression in primary care and its association
with somatic disease such as dementia, diabetes, gastro-enterological
and vascular disease.
2 Functional disease and somatoform disorders: presentation,
determinants and treatment in primary care.
3 Psychiatric morbidity in relation to socio-demographic context and
consultation patterns.
The common background hypothesis is that somatic and psychiatric
disorders share an overlapping etiology and that this overlap has social
and psychological as well as physiological components. Our assessments
typically aim to characterize individuals at several levels (psychological,
physical and physiological).
These themes are studied on the various levels at which disorders mani-
fest themselves:
- The general population, by using existing and developing sampling
frames such as LRGP (Leidsche Rijn Gezondheidsproject), NEMESIS
(Netherlands Mental Health Survey and Incidence Study), AGIS health
database and others.
- Primary health care, in primary care networks such as the Utrecht
General Practitioners Network (In Dutch: HNU (Huisartsen Netwerk
Utrecht), PREDICT, Utrecht Health Project (in Dutch: Leidsche Rijn
Research 39
40 Annual Report 2008
Gezondheids Project) and the database of Emergency Primary Care
service in the Gelderse Vallei area.
- Populations of people with reported mental illness such as those
registered in our psychiatric case registry (PCR-MN).
- Populations of people with reported somatic illness, such as samples of
cardiovascular compromised patients (SMART), (pre)diabetic patients
(UDES), and medication-using people (PHARMO).
This approach of studying the phenomenon of somatic psychiatric
comorbidity at various levels of the health care system is unique. From a
clinical point of view, it will yield information on the etiology and prog-
nosis of somatic-psychiatric co-morbidity and allow preventive inter-
ventions. It will also facilitate evaluation of the patient flow through the
mental health care system and its effectiveness
Most research projects are carried out in collaboration with partners
within primary or secondary care health care: primary care physicians,
secondary care centers for psychiatry, neurology and gastro-enterology,
often in cooperation with other (international) academic centers.
Theoretical Epidemiology and Biostatistics
Besides more applied studies on improving insights in the etiology, diag-
nosis, prognosis and therapy of specific disorders, the Julius Center also
aims to further develop the theory and methodology of the discipline
itself. The section; Theoretical Epidemiology and Biostatistics conducts
studies aiming to improve existing methods and develop innovative
methods for design and analysis of (clinical) epidemiological studies.
The section focuses on the following themes:
- Developing innovative designs for diagnostic and prognostic
(prediction) research.
- Developing innovative methods for quantifying the true or added
value of (new) diagnostic and prognostic tests or biomarkers in a
multivariable clinical context.
- Developing innovative methods for validating and updating so-called
clinical prediction rules.
- Testing and improving methods for dealing with missing values in
epidemiologic research.
- Investigating innovative methods for meta-analysis and individual
patient data-analysis of etiologic and therapeutic studies.
- Development of models to combine data from randomized and
observational studies including genetic information, for estimating
(long term) prognosis according to specific patient characteristics in
addition to treatment effects.
- Developing and investigating methods for sequential analysis in
randomized trials, cumulative meta-analysis, observational
epidemiological and genetic studies, to increase their efficiency and
safety.
- Developing and investigating methods to adjust for confounding in
observational studies, like propensity scores and instrumental
variables.
- Investigating methods for the analysis of longitudinal data.
Notably, the improvement of methods for the design and analysis of
multivariable diagnostic and prognostic research is unique. Most
research in this field focuses on single test or (bio/genetic) marker evalu-
ations, rather than evaluations in a clinical context, accounting for other
test results. The methodology for modeling data from randomized and
non-randomized studies combined is also in its infancy. This type of
Research 41
42 Annual Report 2008
research is situated at the crossroad of clinical epidemiology and medical
technology assessment.
All of the above methodological themes are not only studied on a purely
theoretical level, but are also applied by using empirical data from vari-
ous medical disciplines, notably from our four disease-oriented sections.
For example, data is used from the above-mentioned LRGP (Leidsche
Rijn Gezondheidsproject), the Predict study and the AMUSE studies on
the diagnosis, prognosis and treatment of deep vein thrombosis and
pulmonary embolism, as well as from various other large ongoing stud-
ies in the UMC Utrecht such as the SMART study. It may be obvious
that the results of our methodological studies do not only serve the clin-
ical domains studied, but may serve all medical domains in which diag-
nosis, prognosis and therapy, for example, are at issue.
Most methodological projects are carried out in close collaboration with
other clinical departments from the UMC Utrecht. Other epidemiologi-
cal and (bio) statistical departments from national and international
academic centers are also consulted, such as the Utrecht University,
Academic Medical Center Amsterdam, Erasmus Medical Center
Rotterdam, Dutch National Institute for Health and the Environment,
Vanderbilt University (USA), Harvard University (USA), Oxford
University (UK), and McGill University (Canada).
Research 43
44 Annual Report 2008
Collaboration and affiliations
Collaboration is of major importance in research, both within the UMC
Utrecht and on a national and international basis. Collaboration leads to
the bundling of both expertise and data that no single institute could
produce on its own and, as a consequence, quality and the impact of the
research output increase. The annual citation analyses of the UMC
Utrecht have repeatedly shown that publications resulting from interna-
tional collaborations have significantly higher citation score than aver-
age UMC Utrecht publications.
The Julius Center has a large network of collaborations and - more
structural - affiliations. Over 50 persons have their personal names
attached to the center by means of an honorary appointment. Within
the UMC Utrecht, combined staff appointments have been established
with many clinical disciplines in order to ensure close contact with clini-
cal practice both in the formulation of research questions, conducting
research and implementation of acquired knowledge. The Utrecht
region offers excellent opportunities for collaboration and close links
exist with all epidemiology research groups within Utrecht University,
including IRAS (see below), Pharmacoepidemiology (Utrecht Institute
for Pharmaceutical Sciences) and Veterinary Epidemiology groups and
also with researchers at the Mathematical Institute and from the faculty
of Social Sciences. Also, there are structural relations with the National
Institute for Public Health and the environment (RIVM). One of the
ways in which the collaboration is expressed is the Utrecht University
research focus area Epidemiology. In 2008 funding for this focus and
mass area was used to initiate a Center for Infectious Disease Dynamics,
in which the RIVM also participates.
By nature of its scientific and educational activities, the Julius Center’s
‘playing field’ is the world. Not only is research being published in inter-
national peer-reviewed journals, but an important part of the Julius
Center’s research is also conducted in collaboration with research insti-
tutes and universities in many different countries. Several structural col-
laborations exist, including the European EPIC study which has been
continuous for many years and addresses an ongoing sequence of differ-
ent research questions and the GRACE project, a European Committee-
sponsored network aimed at improving diagnosis and treatment of
respiratory tract infections in primary care.
Other collaborations are more project-based. A recent survey revealed
over forty research projects that are currently ongoing in an internation-
al setting. Several staff members have international affiliations, Professor
Peeters is part time professor at the Imperial College London, and
Professor Moons, Dr Geerlings, Professor Grobbee and Professor Van
Delden also have international affiliations. Similarly, several renowned
international researchers have visiting appointments at the Julius Center.
In addition to the inspiring and productive contacts between staff mem-
bers and fellows with peers all over the world, the Center aims to estab-
lish more extensive long-term structural partnerships with strategically
selected high-quality Academic institutions. These include Imperial
College in London, Boston University and the George Institute for
International Health in Sydney. These and other contacts will play an
important role in the Julius Center’s ambition to stay at the forefront of
international health scientific research and disseminate knowledge to an
international audience of students and health professionals
IRAS
The Institute for Risk Assessment Sciences (IRAS) is an interfaculty
research institute within the Utrecht University faculties of Veterinary
Research 45
46 Annual Report 2008
Medicine, Medicine and the faculty of Science. Both the director,
Professor Brunekreef, and the head of the division of environmental epi-
demiology, Professor Heederik have formal affiliations with the Julius
Center. The institute performs interdisciplinary research that concen-
trates on risk assessment of chemical, physical and biological agents on
man and the environment. It also educates and trains graduate and post-
graduate (PhD) students in the disciplines of toxicology, environmental
and occupational health and epidemiology. The research is performed in
three divisions: Environmental Epidemiology, Toxicology, and
Veterinary Public Health. Research within the Environmental
Epidemiology and Veterinary Public Health Divisions is determinant-
oriented epidemiological research which, in most cases, is conducted in
close collaboration with groups from UMC Utrecht (Julius Center,
Heart and Lung Institute, Wilhelmina Children’s Hospital). The IRAS
input to collaborative projects involves exposure assessment methodo-
logy and advanced exposure response modeling. Specific areas of
research are cancer and exposure to airborne particulate matter, polycy-
clic aromatic compounds, dioxin, organic solvents, allergens and
Microbial Associated Molecular Patterns (MAMPs). There is a particular
interest in exposure to infectious agents and in veterinary public health
issues including zoonoses and exposure to microbial agents through the
food chain.
UU Research Focus Area Epidemiology & the Utrecht Centre for
Infection Dynamics (UCID)
Based on faculty priority areas, Utrecht University has selected fifteen
thematic clusters of research. These focus areas consist of multidisci-
plinary clusters bringing together top-class research groups in each the-
matic field. One of these fifteen fields is Epidemiology, in which epide-
miological research groups collaborate. To quote part of the mission
statement ‘…In close interaction with medical and veterinary specialists
we hope to gain an improved understanding of the origin, diagnosis,
prognosis, treatment and prevention of diseases through research, dis-
semination and education. Our research concentrates on cardiovascular
diseases, cancer, allergy, and infectious diseases, the latter particularly
being relevant to both humans and animals.’ Concrete results from the
collaboration are the PhD program Epidemiology and the Utrecht
Centre for Infection Dynamics (UCID). The latter is a virtual center
that, in collaboration with the RIVM, focuses on interdisciplinary
research in infection disease dynamics.
Examples of international collaboration
Collaborations exist, among others, with the following institutions:
- Berman Center for Outcomes and Clinical Research, University of
Minnesota, Minneapolis, US Department of Clinical Epidemiology,
University of Pretoria, South Africa.
- Clinical Trial Services Unit and Department of General Practice,
University of Oxford, Oxford, UK.
- Departments of Epidemiology and Nutrition, Harvard School of
Public Health, Boston, USA.
- Department of Cancer Epidemiology, Imperial College, London, UK
- Department of Epidemiology, Karolinska Institute, Stockholm,
Sweden.
- Department of Epidemiology, UCSF, San Francisco, USA.
- Department of Food Science and Nutrition, University of Minnesota,
USA.
- Department of Health Evaluation Sciences, University of Virginia
Medical School, Charlottesville, Virginia, USA.
- Department of Neurology, University of Western Ontario, Ontario,
Canada.
Research 47
48 Annual Report 2008
- Department of Public Health, Wake Forest University, Winston Salem,
USA.
- Departments of Nutrition and Cancer, Hormones and Nutrition,
International Agency for Research on Cancer, IARC, Lyon, France.
- Framingham Heart Study, NHLBI, Boston University Medical Center,
Boston, USA.
- George Institute for International Health, Sydney, Australia.
- Medical Research Council London, UK
- Medical Research Council, Dunn, Cambridge, United Kingdom.
- University of Indonesia, Jakarta, Indonesia
- University of Malaya Medical Center (UMMC), Kuala Lumpur,
Malaysia
- University of Tokai, Isehara, Japan
- Wallenberg Laboratory, Sahlgrenska Hospital, Gothenburg, Sweden.
Research Highlights
The year 2008 was very successful for research at the Julius Center. Our
scientific production set a new record in terms of the number of peer-
reviewed publications (more than 400) and PhD thesis defenses in
which a staff member of the Julius was involved as (co-)supervisor
(n=39). Diederick Grobbee and Yolanda van der Graaf ended up being
number 1 and 3, respectively, on the Utrecht University 2008 ‘PhD
Supervisor of the Year’ chart. Also, the quality and impact of our
research output was remarkable in 2008 and this is illustrated by the
large number of publications (a total of 10) in the highest-quality
general medical journals, i.e. the New England Journal of Medicine,
Lancet and JAMA. Several prestigious prizes were awarded to staff mem-
bers from our Center in 2008, including the Heineken award to
Professor Bert Brunekreef, the Catherijne Prize to Professor Diederick
Grobbee and the Elisabeth von Freyburg Medal to Dr Maroeska Rovers.
In addition, many research grants were obtained, including individual
grants, such as the Dekker Stipendium from the Netherlands Heart
Foundation that was awarded to Dr Joline Beulens.
Research 49
50 Annual Report 2008
Education
‘Working on the GP of tomorrow’
(samenwerken aan de huisarts van morgen)
Rob Wolswijk,
Trainee General Practice Vocational Program
Education 53
Educational Organization
Education at the Julius Center is typically organized per discipline. Each
discipline has its own co-coordinator who fine-tunes the different teach-
ing programmes within that particular discipline. In July 2008, the
Biostatistics section joined the Julius Center. Biostatistics was previously
united under the Center for Biostatistics. This Center was responsible
for the education of biostatistics at the faculties of pharmaceutical
s ciences, biology and veterinary medicine. Now, the biostatisticians
operate from the Julius Center, regard this as their home institution and
are still responsible for the biostatistics courses in the different faculties.
The Julius Center participates in numerous educational programmes
covering a broad range of health sciences and primary care. The Center
actively participates in new educational developments such as the UMC
Utrecht’s ambitious undergraduate medicine programme (CRU), which
started in 1999 and was updated in 2006 which is based on interdisci-
plinary problem-oriented learning, and SUMMA, a new 4-year medical
grade program that started in 2004. The majority of educational pro-
grammes are provided in collaboration with other divisions within or
outside the University Medical Center Utrecht. The Center is no longer
responsible for the only Dutch graduate programme for nursing science.
Since august 2008, the University Medical Center Utrecht’s Division of
Education and Research has been in charge of the programme for nurs-
ing science. Among other things, the center is responsible for the special-
ist training of medical doctors as general practitioners in a three-year
vocational training programme. Notably, a new training programme for
a master’s degree in epidemiology was started in 2004, together with
other faculties of Utrecht University. In 2008, the master programme
extended the advanced elective courses and two core courses were com-
pletely revised. Education for the benefit of researchers at the Julius
54 Annual Report 2008
Bachelor
Biostatistics
(Indication of year budget
€ 2,904,000)
Contribution courses in bachelor program’s:
Biology (years 1, 2 and 3)
Veterinary Medicine (year 1)
Pharmaceutical Sciences years 1, 2 and 3)
Medicine (CRU year 3)
Biomedical sciences (BMW, years 2 and 3)
Epidemiology
(Indication of year budget
€ 640,000)
Architecture of Clinical Scientific Research (Architectuur van
Klinisch Wetenschappelijk onderzoek) (CRU year 3)
Elective course Clinical Trials (BMW)
Scientific electives (wetenschappelijke stages) (BMW + CRU)
General Practice
(Indication of year budget
€ 1,130,000)
Orientation medicine (CRU year 1)
Patient care in the Netherlands
(CRU year 1)
Clinical reasoning (CRU year 1)
Public Health
(Indication of year budget
€ 800,000)
Orientation medicine (CRU year 1)
Elective course Health & law (Gezondheidsrecht) (CRU)
Elective course Health care management (Zorgmanagement)
(CRU)
Elective course Diversity (Diversiteit) (CRU)
Elective course Forensic Medicine (Forensische geneeskunde)
(CRU)
Medical Humanities
(Indication of year budget
€ 603,000)
Medical Humanities I (CRU year 3)
Medical Humanities II (CRU year 3)
Nutritional Science
(Indication of year budget
€ 304,000)
Elective course Nutrition in Medicine
(Voeding in de geneeskunde) (CRU)
Nursing Science
(Indication year budget n.a.
discontinued in 2008)
Master
Post-Graduate/
Continuous Professional Education
Contribution courses in MSc programme’s:
Ecology of plant communities and landscapes
Veterinary medicine (year 5)
Pharmaceutical Sciences
SUMMA
Nursing Science
Linguistic Science
Epidemiology
Ten-day introductory course
Number of short (one or two-day) courses
Contribution courses: MSc Epidemiology
Postgraduate (Health Sciences)
MSc programme Epidemiology
(BMS, full two year programme)
START (CRU year 6 + SUMMA year 4)
Scientific electives (wetenschappelijke stages)
(CRU + SUMMA)
MSc programme Epidemiology Postgraduate
(Health Sciences, full 1.5 year programme.
Courses also offered separately)
Discipline Overstijgend Onderwijs
Clinical Epidemiology for Internists (NIV)
Practice of care; nursing apprenticeship
(SUMMA year 1)
Co-assistentschap huisartsgeneeskunde
(SUMMA year 3 + CRU year 5)
Off-ward (SUMMA year 3)
ASAS (SUMMA + CRU)
Scientific and practical electives (SUMMA + CRU)
General Practice
Vocational Training
Post-Academic Education for General Practi-
tioners (PAO-H)
Educational programme NHG Kaderopleiding
Diabetes
Medicine and Society
(Geneeskunde en Maatschappij) (CRU year 5)
START (CRU + SUMMA
Internship (co-schappen) (4 weeks), elective
practicals (6 weeks), BSAS (12 weeks)
Scientific electives (wetenschappelijke stages)
(12 weeks) both national and international
Integrated Care master classes and symposia
Study visits to Kaiser Permanente USA and
Canada
Educational programme ‘Justitieel
Geneeskundigen’
START (CRU year 6 + SUMMA year 4)
MSc programme Nursing Science (Gezondhe-
idswetenschappen, full one year programme)
Reading and judgment scientific (nursing sci-
ence) research
Education 55
Bachelor
Biostatistics
(Indication of year budget
€ 2,904,000)
Contribution courses in bachelor program’s:
Biology (years 1, 2 and 3)
Veterinary Medicine (year 1)
Pharmaceutical Sciences years 1, 2 and 3)
Medicine (CRU year 3)
Biomedical sciences (BMW, years 2 and 3)
Epidemiology
(Indication of year budget
€ 640,000)
Architecture of Clinical Scientific Research (Architectuur van
Klinisch Wetenschappelijk onderzoek) (CRU year 3)
Elective course Clinical Trials (BMW)
Scientific electives (wetenschappelijke stages) (BMW + CRU)
General Practice
(Indication of year budget
€ 1,130,000)
Orientation medicine (CRU year 1)
Patient care in the Netherlands
(CRU year 1)
Clinical reasoning (CRU year 1)
Public Health
(Indication of year budget
€ 800,000)
Orientation medicine (CRU year 1)
Elective course Health & law (Gezondheidsrecht) (CRU)
Elective course Health care management (Zorgmanagement)
(CRU)
Elective course Diversity (Diversiteit) (CRU)
Elective course Forensic Medicine (Forensische geneeskunde)
(CRU)
Medical Humanities
(Indication of year budget
€ 603,000)
Medical Humanities I (CRU year 3)
Medical Humanities II (CRU year 3)
Nutritional Science
(Indication of year budget
€ 304,000)
Elective course Nutrition in Medicine
(Voeding in de geneeskunde) (CRU)
Nursing Science
(Indication year budget n.a.
discontinued in 2008)
Master
Post-Graduate/
Continuous Professional Education
Contribution courses in MSc programme’s:
Ecology of plant communities and landscapes
Veterinary medicine (year 5)
Pharmaceutical Sciences
SUMMA
Nursing Science
Linguistic Science
Epidemiology
Ten-day introductory course
Number of short (one or two-day) courses
Contribution courses: MSc Epidemiology
Postgraduate (Health Sciences)
MSc programme Epidemiology
(BMS, full two year programme)
START (CRU year 6 + SUMMA year 4)
Scientific electives (wetenschappelijke stages)
(CRU + SUMMA)
MSc programme Epidemiology Postgraduate
(Health Sciences, full 1.5 year programme.
Courses also offered separately)
Discipline Overstijgend Onderwijs
Clinical Epidemiology for Internists (NIV)
Practice of care; nursing apprenticeship
(SUMMA year 1)
Co-assistentschap huisartsgeneeskunde
(SUMMA year 3 + CRU year 5)
Off-ward (SUMMA year 3)
ASAS (SUMMA + CRU)
Scientific and practical electives (SUMMA + CRU)
General Practice
Vocational Training
Post-Academic Education for General Practi-
tioners (PAO-H)
Educational programme NHG Kaderopleiding
Diabetes
Medicine and Society
(Geneeskunde en Maatschappij) (CRU year 5)
START (CRU + SUMMA
Internship (co-schappen) (4 weeks), elective
practicals (6 weeks), BSAS (12 weeks)
Scientific electives (wetenschappelijke stages)
(12 weeks) both national and international
Integrated Care master classes and symposia
Study visits to Kaiser Permanente USA and
Canada
Educational programme ‘Justitieel
Geneeskundigen’
START (CRU year 6 + SUMMA year 4)
MSc programme Nursing Science (Gezondhe-
idswetenschappen, full one year programme)
Reading and judgment scientific (nursing sci-
ence) research
56 Annual Report 2008
Center takes place by means of participation in recognized graduate
schools such as the Netherlands Institute for Health Sciences (NIHES)
(www.nihes.nl), Infection & Immunity (www.eijkmanschool.org),
Psychology and Health (http://pandh.fss.uu.nl), and ImagO (www.
imago.uu.nl). The number of educational programmes is growing each
year. The Center supports the training of lecturers and in 2008 one staff
member obtained a senior teaching qualification (SKO) and another
gained a basic teaching qualification (BKO). The table on page 54-55
summarizes the programmes (original names of the courses) that are
coordinated by staff-members from the Julius Center. A more detailed
description can be found in the specific chapters and on the website.
Education 57
General Practice
Introduction
The General Practice staff of the Julius Center participates in various
courses and ongoing educational programmes at several levels in the
medical curriculum (bachelor, master). Besides these activities, there is a
three year vocational training programme and is continuous medical
education provided.
The primary purpose of all of these courses is to teach students the prin-
ciples and methods of general practice, for the trainees in the vocational
training programme to become competent general practitioners and for
the general practitioner to keep his competencies on the optimal level.
Medical Bachelor and Master, CRU
Description
At the university medical school, traditionally a three year period of
acquisition of knowledge and skills is followed by three years of intern-
ships, where people gain their basic medical experience in teaching hos-
pitals and (for 6 weeks) in general practice. During the last decade the
period of practical experience in internships has been partially moved
forward to the 3rd year of the Bachelor. This step was motivated by evi-
dence that theoretical education, in combination with practical experi-
ence, allows students to construct their own knowledgebase more effi-
ciently and more effectively. It gives a student more opportunities for
learning within the context of his future work.
In short two trends are visible in undergraduate teaching, one is early
internships and the second is realizing a better link between undergrad-
uate and post graduate teaching to make the 3rd year of the Master more
58 Annual Report 2008
of a transition year between undergraduate teaching and the specializa-
tion or postgraduate teaching.
Course information
In every class-year 300 students are taught. The department of general
practice is responsible for the introductory course for new medical stu-
dents (1st year). In the last two weeks of this 5-week course most stu-
dents gain experience in clinical practice during a nursing apprentice-
ship and a small number of them (24 students) are able to participate in
an observational apprenticeship in general practice.
All educational programmes are problem-oriented and several disci-
plines collaborate in each course.
General practice contributes and coordinates to the following courses:
Course
Coordination/
contribution
Number of
partici-
pants
% passed
exam
Evaluation
marks
Orientation in Medicine, first year Coordination 300 95% 6.9
Nursing/GP apprenticeship, first year Coordination 300 100% 7.3
Students following patients pro-
gramme, first year
Coordination 300 na 6.6
Clinical reasoning programme, first year Coordination 300 80% 6.5
Students following patients pro-
gramme, second year
Coordination 15 93% 7.7
Eye-diseases, second year Contribution 288 na na
Medicine and society, second year Contribution 288 na na
Metabolism, second year Contribution 290 na na
Infection and immunity, third year Contribution 290 na na
Acute medicine, third year Contribution 290 na na
GP Internship, second year (6 weeks) Coordination 288 99% 8.2
GP Practical electives, second year
(6 weeks)
Contribution 18 100% na
GP Internship, third year (12 weeks) Contribution 46 100% na
Education 59
GP Scientific electives, third year
(12 weeks)
Contribution 17 100% na
GP Practical electives, third year
(6 weeks)
Contribution 15 100% na
Medical Master, SUMMA
Description
In the first and the second year of the SUMMA masters programme all
students (40 students annually) are trained in clinical reasoning by GP
staff members. In addition, most students gain experience in clinical
practice during a nursing apprenticeship in their first year. Five students
per year will be offered the opportunity to participate in an observation-
al apprenticeship in general practice. In the third year all students have a
five week internship in general practice, while two or three students are
supervised annually in a longer internship of 12 weeks and in a scientific
elective in the 4th year.
Course
Coordination/
contribution
Number of
partici-
pants
% passed
exam
Evaluation
marks
Nursing apprenticeship, first year Coordination 40 100% 7.9
Clinical reasoning, first and second year Contribution 40 na na
GP Internship, third year (6 weeks) Coordination 36 100% 8.3
GP Internship, fourth year (12 weeks) Contribution 3 100% na
GP Scientific elective, fourth year
(12 weeks)
Contribution 2 100% na
General Practice Vocational Training (Postgraduate)
Description
In the Netherlands general practice vocational training is offered by 8
Institutes for Postgraduate Training. One of them is the Julius Center
where each year 72 trainees start with the 3-year programme. In the
60 Annual Report 2008
coming two years the number of trainees will grow to 84 trainees a year.
The three-year course consists of two years of training in general prac-
tice and one year in hospitals, health care institutes and nursing homes.
In order to serve the needs of the course, there is close cooperation with
213 general practitioners, 7 peripheral hospitals, 22 nursing homes and
18 regional institutes for outpatient mental health care. The trainees
attend the department of general practice for reflection and training one
day a week.
In close cooperation with the other university centers and the Dutch
College of General Practitioners several educational and ICT manage-
ment tools have been developed including the construction of a core
competency oriented curriculum. The main advantage of this coopera-
tion is the exchange of experience on a national level, allowing us to
learn from each other and become stimulated to improve our own
results. The cooperation in the Julius Centre is especially relevant to the
subject of EBM education.
We do recognize and certify previous postgraduate experience in teach-
ing hospitals. In half of the cases, this leads to a mean reduction of the
training period of 6 months.
Since 2006 the curriculum is competency oriented. The seven compe-
tencies are: medical expertise, doctor patient communication, collabora-
tion, management, social accountability, science and education and pro-
fessionalism. In such a competency oriented curriculum you need an
adequate assessment programme. The trainee then adjusts his or her
individual learning and development plan on the basis of an assessment.
An extensive assessment programme has been developed in Utrecht and
also in the other departments in the Netherlands. There is a Go/No Go
decision taken at the end of the first year.
Education 61
Course information
Each of the three training years has different characteristics. In the first
year the emphasis is on obtaining and sharpening skills in general prac-
tice. In the second year, particular attention is paid to the cooperation
between the GP and specialists and training in special skills by doing
internships in hospitals and Regional Institutes for Outpatient Mental
Health Care and Nursing Homes. In the third-year, the acquisition and
integration of in-depth knowledge takes center stage. Every effort is
made to increase the expertise and quality of future GPs.
Networks of general practices appear now and then, with franchising
formulas and central management.
They tend to organize their own facilitating services in order for groups
of GP practices to gain more efficiency and more competitive power.
Within general practice, one can perceive a trend of differentiation
between GPs and GP groups. This means that new tasks are taken up by
reasonably specialized GP’s within a group and this then creates oppor-
tunities to distribute tasks between the GPs. By doing so, one can a high-
er level of care as a result of cooperation.
That is why there are possibilities for differentiation in the new curricu-
lum.
Course titles
First year: four days of general practice training in medical practice and
a day-release course for one day, with different topics.
Second year: internship in emergency department general hospital,
mental health and nursing home.
Third year: four days of general practice training in medical practice,
differentiation on management/ education/ science/ special interest like
diabetes, asthma, COPD, cardiovascular risk management.
62 Annual Report 2008
Output 2008
Number of students
In just a few years, capacity has been increased to 216 trainees in 2008.
- Number of students who started their GP training in 2008: 74
- Number of students who finished their GP training in 2008: 70
Advanced Training in General Practice
(Continuing professional education)
Description
This involves post-academic training for general practitioners (Post
Academisch Onderwijs voor Huisartsen, PAOH-Utrecht). The focus is
on information for GPs that is up-to-date, evidence based and relevant
to general practice. The courses are interactive and use an interactive
voting system. All speakers are experts on their topic.
Also the ‘NHG kaderopleiding Diabetes’ is coordinated by staff members
of the Julius Center.
Course information PAOH
In 2008 the Julius Center organized 9 days (each of 6 accreditation
points) and 2 afternoons (PAOH EXTRA, 3 accreditation points) for
GPs in the Netherlands.
Course titles (in Dutch) Course Course dates Number of participants
Diagnostiek Feb 1 191
Onbegrepen klachten Apr 4 170
Neus en longen Apr 24 69
Hart- en vaatziekten May 23 150
Reizigersgeneeskunde Jun 12 146
Education 63
Geriatrie Sep 19 145
Zorg rondom het levenseinde Oct 3 171
11e Diabetesdag Nov 6 96
Neurologie Dec 19 130
Huisarts van nu (EXTRA) Mar 6 60
De basis van de standaarden (EXTRA) Mar 6 62
Output 2008
80-200 GPs attended each course (with a total of around 1200 GPs)
Evaluation
PAOH courses consistently receive good evaluations.
64 Annual Report 2008
Epidemiology
Medical Bachelor
AKWO (architectuur van klinisch wetenschappelijk onderzoek)
- Architecture of clinical scientific research
Brief course description
In modern medicine, physicians ask themselves continuously to what
extent their medical decisions (diagnostic, therapeutic, prediction of
prognosis) are based on solid scientific evidence. This 6-week full time
course will equip medical students with the basic knowledge and skills
of clinical epidemiology.
In order to be able to value and interpret scientific reports, students will
need to acquire their own research experience. During this course stu-
dents will learn how scientific knowledge is generated. We give the stu-
dents a taste of the various aspects of clinical scientific research by simu-
lating the entire process of a scientific research project.
They will learn how to define a research question, select the appropriate
study design to answer this question, prepare a research protocol, collect
data, analyze it, interpret results, report and present the findings. At the
end of this course students will be able to differentiate between the dif-
ferent study designs, methods and analytic techniques of etiological,
diagnostic, prognostic and therapeutic research.
Students work in small teaching groups, on practical assignments, and
in workshops and participate in ‘meet the expert’ meetings.
This course runs 12 times a year for groups of 25 students. Each time the
course is constructed around a(nother) clinical problem, for example
chest pain or neurological deficits and each year approximately six clini-
cal problems will be discussed. The selection of clinical problems is
based on the problem’s frequency of occurrence and the clinical and
Education 65
research expertise of the supervisors. Therefore, although this is not the
main objective of the course, students will improve their incidental
knowledge etiology, diagnosis, prognosis and therapy of the clinical
problem chosen.
Course Course dates Number of participants % passed exam Evaluation marks
AKWO 12 courses between
Aug 2007– Jul 2008
263 97% 7.0
Medical Master of Science Degree
Evidence based medicine
START module and Return Days
(in Dutch ‘Startblok en Terugkomdagen’)
Brief description of course content
In modern medicine, physicians ask themselves continuously to what
extent their medical decisions (diagnostic, therapeutic, prediction of
prognosis) are based on solid scientific evidence. This 6-week part time
course during the final 6th year of medical school will equip medical stu-
dents with the principles of evidence based medicine and applied
knowledge and skills of medical evidence management. This course
builds on the skills and knowledge acquired during the AKWO course
during the 3rd year of medical school.
In order to be able to apply best available evidence in patient care, stu-
dents will need to acquire their own experience with medical evidence
management. During this course students will learn how to write a case
report: a 1200 word comprehensive summary of best available evidence
on questions concerning the management of a particular patient. These
focus on a foreground question, i.e. an applied problem of diagnostic,
AsiaLink Clinical Epidemiology & Evidence Based Medicine
This EU funded project, initiated by the Julius Center, is a collaboration
between the University Hospital Cipto Mangunkusomo (Jakarta Indonesia),
the University of Malaya (Kuala Lumpur Malaysia), the University of Oxford
(UK) and the University Medical Centre Utrecht. The aim is to establish a
platform for a durable improvement and collaboration in clinical epidemio-
logical teaching and research in Indonesia and Malaysia. Specific actions
include a teaching mission, PhD fellowships and the set-up of a Clinical
Epidemiology Support Unit in Jakarta and Kuala Lumpur. The project start-
ed in November 2007 and will run until October 2010.
Teaching mission, post-graduate
During the first year of the programme, four basic and four advanced post-
graduate courses have been offered, in which a total of 380 medical doc-
tors / clinical researchers / health policy makers participated. For an over-
view of the courses see the chapter on education.
Teaching mission, under-graduate
After several rounds of meetings between educational specialists, university
administration and professors of the Julius Center and the two Asian insti-
tutions, we have now developed an undergraduate module in clinical epi-
demiology and evidence based medicine, tailored to the Asian context. The
module has been adapted from the third year module on clinical epidemi-
ology and fourth year module on Evidence-Based Medicine of the
University Medical Center Utrecht. In both Asian institutions, the module
has been embedded in the medical curriculum. In Jakarta, some 200 fourth
year medical students will start a five week, full time module in May 2009,
66 Annual Report 2008
and in Kuala Lumpur, around 200 third year medical students will start a 13
week, part-time module in August 2009.
PhD fellowships
In early 2008, we selected a first group of PhD fellows (2 from Kuala
Lumpur and 2 from Jakarta). This fellowship includes training in Clinical
Epidemiology in Utrecht/Oxford, followed by a PhD research project, in
close collaboration and under the mentorship of Julius Center professors.
In September 2008, three medical doctors from Jakarta and Kuala Lumpur
started the one year postgraduate MSc training programme in Clinical
Epidemiology at the Julius Center and one fellow started her PhD training
in Oxford, under the supervision of Prof Glasziou.
In October and December 2008, we held new selection rounds and we have
now selected an additional 7 PhD fellows (4 from Indonesia, 3 from Kuala
Lumpur) who will start their MSc Clinical Epidemiology at the Julius Center
in September 2009.
Set up of Clinical Epidemiology Support Unit at RS Cipto Mangunkusumo
and University Malaya.
The Julius Centre University Malaya (JCUM), Centre for Clinical
Epidemiology and Evidence-Based Medicine, has now officially been estab-
lished at the University of Malaya. At University of Malaya and RS Cipto
Mangunkusumo, office space has been made available to host the CE &
EBM Coordination Unit and in both institutions a full time project officer
has been employed.
Project management
Project coordination, monitoring and evaluation:
The Steering committee consists of Prof Yolanda van der Graaf, Prof Arno
Hoes, Prof Diederick Grobbee (all University Medical Center Utrecht), Prof
Education 67
Awang Bulgiba (University Malaya Kuala Lumpur), Prof Sudigdo
Sastroasmoro (RS Cipto Mangunkusumo Jakarta), Prof Paul Glasziou
(University of Oxford), Dr Helena Verkooijen (University Medical Center
Utrecht, based in Singapore).
During several meetings, attended by the members of the steering commit-
tee (April 08 and Oct 08, in Kuala Lumpur and Jakarta), the roles, responsi-
bilities, rights and mutual obligations of the different partners were speci-
fied in a Memoranda of Agreement between the four partners.
Stakeholder communication is taking place through our website
(www.asialink-ce.org), biannual newsletters, press conferences during the
official launches of the project in both Kuala Lumpur (19th Nov 2007) and
Jakarta (17th April 2008) and publicity talks at conferences, embassies, other
tertiary education institutions in the region.
68 Annual Report 2008
Education 69
prognostic and therapeutic patient management rather than on a theo-
retical or conceptual scientific background problem.
For this we teach them to adequately translate the problem into a well
phrased research question, efficiently retrieve and select the best avail-
able evidence and tabulate and translate it in terms of clinical patient
management.
We use small teaching groups, with practical assignments, workshops
and meet the expert meetings.
During their subsequent 24 week internship at the clinical ward, stu-
dents are given an assignment to write 3 case reports per couple. Each
student reviews and grades 6 case reports of other students.
Course Course dates Number of participants % passed exam Evaluation marks
EBM module
START
6 courses between
Aug 2007 – Jul 2008
270 100% 7.6
SUMMA Scientific Education 2
(in Dutch: ‘Wetenschappelijke Vorming-2’)
During this course, students of the Selective Utrecht Medical Master’s
(SUMMA) Programme will learn about the theory of risk and the epide-
miologic design of diagnostic, prognostic and experimental research in
plenary lectures and moderated small student groups.
At the end of this course students will be able to differentiate between
the different study designs, methods and analytical techniques of etio-
logical, diagnostic, prognostic and therapeutic research, and have
learned how to value and interpret scientific reports, as well as how to
define a research question, select the appropriate study design to answer
this question and prepare a research protocol.
This course runs once a year for groups of 40 students.
70 Annual Report 2008
Course Course dates Number of participants % passed exam Evaluation marks
SUMMA May 2007 40 100% 6.7
Biomedical Master of Sciences Degree
Epidemiology Research Master’s Programme
Brief description of programme content
The Utrecht University Graduate School of Life Sciences offers two
Epidemiology Research Master’s programmes which are organized by
research groups at UMC Utrecht (Julius Center) and Utrecht University
(IRAS, Veterinary Epidemiology, and Pharmaco-epidemiology):
- ‘Epidemiology’, a 2-year programme within Biomedical Sciences,
aimed at students holding a Bachelor of Science degree in Biomedical
Sciences, (Veterinary) Medicine or Pharmaceutical Sciences.
- ‘Epidemiology Postgraduate, an 1.5-year postgraduate programme
within Health Sciences, aimed at professionals holding a Master’s of
Science degree in Life Sciences or (Bio-)Medical Sciences, Medicine
(MD), Pharmaceutical Sciences (PharmD), or Veterinarian Medicine
(DVM).
The two main components of the programmes are:
- comprehensive theoretical education in the principles and methods of
epidemiological research;
- a practical research project in which the theory can be applied;
rounded off with the writing of a scientific paper and an oral
presentation.
Students are provided with extensive knowledge and practical skills in
patient-oriented research, including design and quantitative analysis.
The knowledge and skills gained form a solid basis for health research
Education 71
and disease control programmes, including application in developing
countries.
The programmes provide specializations in Clinical Epidemiology,
Epidemiology of Infectious Diseases, Pharmaco-epidemiology,
Occupational and Environmental Epidemiology, or Veterinary
Epidemiology.
More information: www.msc-epidemiology.nl.
Course Course dates
Number of
participants
% passed
exam
Evaluation
marks
Introduction to Epidemiology 3-14 Sep 2007 50 100% 7.6
Study Design 24 Sep – 12 Oct
2007
43 91% 7.5
Clinical Epidemiology 12 - 30 Nov 2007 34 100% 6.8
Presentation and writing of
research proposal
4 – 8 Feb 2008 29 100% 7.4
Advanced Diagnostic Research 3 – 7 Mar 2008 42 100% 7.3
Prognostic Research 31 Mar – 4 Apr
2008
40 100% 7.5
Clinical Trials and Drug Risk
Assessment
21 – 25 Apr 2008 42 98% 6.8
Basics of advanced mathematical
modeling of infectious diseases
26 - 30 May 2008 18 100% 7.4
Advanced mathematical modeling
of infectious diseases
2 – 6 Jun 2008 14 79% 7.1
Nutritional Epidemiology 24 – 28 Nov 2008 29 96% 7.8
Continuing Professional Education
Clinical Epidemiology (NIV)
Brief description of programme content
This 1-day course on the principles of Clinical Epidemiology and
Evidence Based Medicine for members of the Dutch Society of Internal
72 Annual Report 2008
Medicine (NIV), in particular for residents and registrars, includes ple-
nary lectures on methods of applied research and evidence based medi-
cine and small moderated student groups. At the end of this course par-
ticipants are familiar with the principles of epidemiological study design
for diagnostic, prognostic and intervention research and are able to criti-
cally appraise clinical medical research papers and clinical guidelines.
Evidence Based Medicine
(Discipline Overstijgend Onderwijs)
Brief description of programme content
This 2-day course on the principles of Evidence Based Medicine for
clerks and residents at UMC Utrecht and collaborating teaching hospi-
tals, includes plenary lectures on methods of applied research and evi-
dence based medicine, small moderated student groups and additional
lectures provided by external speakers.
At the end of this course, participants are familiar with the principles of
epidemiological study design for etiologic, diagnostic, prognostic and
intervention research, are able to coherently formulate a clinical ques-
tion, search databases, critically appraise clinical research papers, clearly
summarize and present available evidence and critically consume clini-
cal guidelines.
Course Course dates
Number of
participants
% passed
exam
Evaluation
marks
EBM DOO 24 Jan - 7 Feb 2008 40 100% 7.8
NIV One day clinical epidemiology course for
internal physicians in training. Course
given on 17 Apr 2008 and on 9 Oct 2008
147 in Apr
135 in Oct
100% 6.9 in Apr
6.8 in Oct
Education 73
AsiaLink Clinical Epidemiology & Evidence Based Medicine
This EU funded project, initiated by the Julius Center, is a collaboration
between the University Hospital Cipto Mangunkusomo (Jakarta
Indonesia), the University of Malaya (Kuala Lumpur Malaysia), the
University of Oxford (UK) and the University Medical Center Utrecht.
The aim is to establish a platform for a durable improvement and col-
laboration in clinical epidemiological teaching and research in Indonesia
and Malaysia. Specific actions include a teaching mission, PhD fellow-
ships and the set-up of a Clinical Epidemiology Support Unit in Jakarta
and Kuala Lumpur. The project started in November 2007 and will run
until October 2010. For more information see the ‘yellow pages’ else-
where in the year report. Below you will find the overview of courses
taught by Julius Center staff.
Course Date Location Level Faculty
Number of
participants
Evidence Based Medicine Apr 2008 University Malaya Basic Oxford 24
Clinical Epidemiology Apr 2008 RSCM Jakarta Basic Utrecht 58
Clinical Trials Apr 2008 RSCM Jakarta Advanced Utrecht 61
Evidence Based Medicine Apr 2008 RSCM Jakarta Basic Utrecht 24
Basic Epidemiology Nov 2008 RSCM Jakarta Basic Utrecht 37
Prognostic Research Dec 2008 University Malaya Advanced Utrecht 60
Clinical Trials Dec 2008 University Malaya Advanced Utrecht 55
Diagnostic Research Dec 2008 RSCM Jakarta Advanced Utrecht 61
74 Annual Report 2008
Public Health
The educational programme of Public Health defines the main focus of
the principles and methods of healthcare research, structure, quality,
finance and functioning of healthcare systems, with a focus on Social
Medicine and Public Health interventions.
Medical bachelor
In the first year of the bachelor phase, the course ‘Orientation to Medi-
cine’ (‘Orientatie Geneeskunde’) is offered. In this course, the main out-
lines of the organization of healthcare are the focus point. An internship
in a nursing home or a care institution of a different kind is part of this
course. Last year the average result of the evaluation by students was 7.
In the second year 4 optional courses of five weeks each are offered,
namely:
- ‘Care Management’ (‘Zorgmanagement’): The main objectives of this
course are the improvement of competence in the area of knowledge of
care management, co-operating within a multidisciplinary context and
communication with different kinds of professionals.
- ‘Law and Medicine’ (‘Gezondheidsrecht’): This course is centered
around the legal and regulatory framework of the Dutch health care
system, with a focus on the professional competence of doctors.
- ‘Diversity in prevention, illness and care’ (‘Diversiteit in preventie,
ziekte en zorg’): This course is set up to create and stimulate the
awareness of the presence and influence of diversity in the medical
profession.
- ‘Forensic Medicine’ (‘Forensische geneeskunde’): This course was
started for the first time and was a great success. A broad definition of
forensic medicine is used. It deals with aspects of legal and regulatory
Education 75
frameworks, forensic research, cooperation with the police and
identification experts in combination with medical expertise. The
excursions to forensic pathology, a prison, police forensic research,
military forensics and identification teams and an asylum center were
impressive.
Course Evaluation marks
Care Management’ (‘Zorgmanagement’) 8.0
Law and Medicine (‘Gezondheidsrecht’) 8.1
Diversity in prevention, illness and care’ (‘Diversiteit in preventie,
ziekte en zorg’)
n.a
Forensic Medicine’ (‘Forensische geneeskunde’) 7.9
Medical master
In year 5 the course ‘Medicine and Society’ is offered. Matters that are
being discussed within this course include aspects of health and health-
care and the ‘grey area’ between curative forces and society. Obligatory
internships in social medicine for a period of four weeks are connected
to this course.
In year 5 the course ‘TLO’ is also offered. In this course, themes in
patient safety are studied. Last year’s result is lower than expected. A
whole new programme on patient safety has been developed. Important
input was given by the staff bureau of the UMC Utrecht and their
patient safety department.
Year 6 focuses on the decision making processes in healthcare in emer-
gency situations and the organization, quality and finance of healthcare.
Examples of new providers of care in the mental health sector and the
introduction of new evidence based interventions in mental health dis-
ease management programmes are dealt with.
76 Annual Report 2008
Optional internships of six weeks are part of the possibilities in the 4th,
5th and 6th year. In year 6 it is possible to do a BSAS, a scientific intern-
ship or an educational internship within the division of Public Health. It
is possible to do these internships and optional internships abroad.
All of the excellent internships were possible due to effective cooperation
with more than 100 affiliation partners within the public health sector.
Postgraduate / Continuing Professional Education
The post graduate education division provides additional and refresher
courses like symposia and conferences for graduated doctors. All of the
courses are accredited.
In cooperation with many foreign and non-foreign guest teachers, the
Public health division provides additional courses for professionals in
healthcare, set up in the form of conferences, courses, workshops and
study trips.
For more information visit the Julius Center’s webpage
www. juliuscenter.nl or for an overview on the different activities go to
www.integratedcare.nl, via ‘nascholing’.
Education 77
Biostatistics
The biostatistics group is responsible for most of the statistical courses
taught in the faculty of Medicine and the faculty of Science’s depart-
ments of Biology and Pharmaceutical Sciences.
Bachelor and Master’s Degree
The amount of statistics education is quite diverse in the various facul-
ties:
In Biology a compulsory 7.5 ECTS course covers descriptive statistics,
theory of testing and estimation, various T-tests, Chi-square test, corre-
lation and regression and one-way ANOVA. It is followed by an elective
7.5 ECTS course, which includes various other kinds of ANOVA, multi-
variate techniques, logistic regression, survival analysis and methods for
dependent data.
In contrast, in Medicine (CRU2006) our contribution is restricted to
three afternoons in the 6-week AKWO course, where statistics is not
taught as an independent discipline, but more as part of achieving the
goal of that course, i.e. simulation of the process of a scientific research
project.
The amount of statistics taught in the bachelor programmes of
Biomedical Sciences, Health Sciences and Pharmaceutical Sciences lies
between these two extremes.
In almost all of our courses the theoretical knowledge gained in lectures
is reinforced by practical and computer lab sessions, using the statistical
programmes SPSS and occasionally R. This should enable students to do
their own analyses, although in practice we see quite a lot of them again,
when they do their own research.
78 Annual Report 2008
Postgraduate and Continuing Professional Education
Lastly we also provide some extra-curricular courses for researchers
(mainly) from the biomedical faculties. This includes a 2-week course
(Introductory Biostatistics for Researchers) given 2-3 times a year, in
which the latent statistical knowledge of researchers is refreshed and
some 1, 2 or 3 day courses on advanced subjects.
In the table a partial list of the major courses is provided.
Course Faculty /programme
Course
dates
Number
of partic-
ipants
%
passed
exam
Evalua-
tion
marks
Applied Biostatistics 1,
BSc second year
Science / Biology Nov
2007-
Feb 2008
170 73 % 5.7
Applied Biostatistics 2,
BSc third year
Science / Biology Sep-
Nov 2008
20 n.a. n.a.
Fa107, BSc first year Science / Pharm. Sc. Jun 2008 220 n.a. n.a.
Population, BSc
second year
Medicine / Biomedical Sc. Feb-Apr
2008
116 n.a. 5.0
Clinical trials, BSc third
year
Medicine / Biomedical Sc. Nov- Dec
2008
9 100 % 7.6
Statistics 1, Premaster
first year
Medicine / Health Sc. Sep 2008
- Jan
2009
81 81% 7.6
Statistics 2, Premaster
first year
Medicine / Health Sc. Feb-Jun
2008
56 93% 7.2
Methods & Statistics,
MSc first year
Medicine / Nursing Sc. Jan-Feb
2008
47 93% 7.7
AKWO, BSc third year Medicine / CRU2006 12
courses
Jul 2007 -
Jun 2008
263 97% 7.0
Introduction to Statis-
tics, MSc first year
Medicine / Biomedical Sc. /
Epidemiology
Sep 2008 45 n.a. n.a.
Education 79
Classical methods, MSc
first year
Medicine / Biomedical Sc. /
Epidemiology
Oct –
Nov 2008
44 93% 7.7
Modern methods, MSc
first year
Medicine / Biomedical Sc. /
Epidemiology
Jan 2008 37 92% 7.4
Introductory
Biostatistics for
Researchers
Extracurricular Apr, Jun
& Oct
2008
71 n.a. 7.8
80 Annual Report 2008
Medical Humanities
Overview
Medical humanities is a term which we use for an interdisciplinary field
in which the humanities, sociology and arts come together. The humani-
ties are medical ethics, health law, history of medicine and philosophy of
medicine. Sociology is medical anthropology and medical sociology and
with arts we mean literature, theatre and movies.
The aim of this course is to help the student become a better physician:
- By providing insight into the human condition, complementary to his
or her biomedical knowledge
- By providing a better understanding of the responsibilities and duties
physicians have to their patients and society
- By showing that the art of medicine is performed within a cultural and
societal context which is characterized by diversity and by showing that
this context also shapes the experience of being ill and the way
medicine is performed
- By further developing the student’s competence for observing,
analyzing, empathy and self-reflection.
Bachelor
In the third year of the curriculum CRU2006 two courses of four weeks
each will be devoted to Medical Humanities. All students will have to
take both courses. Evaluations cannot currently be given as this course
has only recently started.
Course Course dates
Number of
participants % passed exam
Evaluation
marks
Medical Humanities I Start Sep08 312 Not yet available Not yet available
Medical Humanities II Start Sep08 312 Not yet available Not yet available
Education 81
Master’s Degree
In the master’s phase of CRU2006 no integrated courses in medical
humanities are given. Nonetheless, some of the disciplines of medical
humanities, especially health law and medical ethics will contribute to
courses, e.g. the starting course in the sixth year and in the honors pro-
gramme.
Postgraduate / Continuing Professional Education
Contribution to the Clinical Epidemiology course in the postgraduate
Epidemiology master.
82 Annual Report 2008
Nursing Science
Overview
In 2000, a Dutch Master of Science degree for the Health Sciences pro-
gramme was established at Utrecht University (UU). Nursing Science
was the first major field of study to be offered within the Health Sciences
programme. Physiotherapy Science was added as a second major field of
study in 2002 and Speech Therapy Science as the third field in 2003.
However, a new curriculum for the Health Sciences programme was
necessary in order to comply with the European regulations for universi-
ty education and to conform with the international Bachelor-Master
structure in higher education. This resulted in the development of a two
year part-time master programme (60 ects) for graduates of a BSc-
university degree programme or a premaster programme (see Bachelor).
The MSc master Nursing Science programme started in September 2005.
In July 2006, accreditation of the master programme was given by the
External Accreditation Committee (EAC) - a committee appointed by
the Ministry of Education and responsible for accrediting all university
programmes. The accreditation is valid until July 2012.
The Department of Nursing Science within the Julius Center for Health
Sciences and Primary Care is responsible for the development and coor-
dination of the Nursing Science field of study.
Bachelor
Description
At the moment the Utrecht University does not offer a Health Sciences
bachelor programme. Instead, a one year part-time pre-master pro-
gramme (30 ects) was developed for graduates of a bachelor degree pro-
gramme in professional education who want to continue their education
at a university master level.
Education 83
Programme information
Course Course dates EC
Number
of partici-
pants
%
passed
exam
Evalua-
tion
marks
Premaster Nursing Science Sep 2007 – Sep 2008 30
Project and Academic Skills Sep 2007 – Sep 2008 7.5 57 80 7.8
Philosophy, Science and Ethics Sep 2007 – Sep 2008 7.5 57 80 7.7
Research Methods Sep 2007 – Sep 2008 7.5 57 80 7.8
Statistics Sep 2007 – Sep 2008 7.5 57 80 7.6
Master
Description
The MSc Nursing Science programme is a two year part time academic
master’s course. Students are educated and trained in four roles: aca-
demic professional, researcher, innovation and information manager. As
a consequence the student is able to bridge the world of science and
nursing practice, and contribute to the development and scientific foun-
dation of nursing.
MSc Programme information
Course
Course
dates EC
Number of
participants
%
passed
exam
Evaluation
marks
Master Nursing Science 09/07–09/08 60
Nursing innovation theory and man-
agement
09/07–10/07 6.5 56 98 7.8
Innovation development and imple-
mentation
11/07–12/07 6.5 56 98 7.7
Research Methods & Statistics 01/08–02/08 2 56 100 7.7
Systematic Literature Review 01/08–03/08 7.5 60 85 7.5
Science and Nursing Practice 04/08–07/08 6.5 60 90 7.6
Elective course 09/07–12/08 6 60 100 n.a.
84 Annual Report 2008
Master’s thesis: proposal and prepara-
tion
09/07–12/08 8 65 89 7.9
Master’s thesis: conduct and reporting 01/08–07/08 15 65 89 7.9
Portfolio 09/07–09/08 2 65 100 n.a.
For more detailed information (in Dutch) concerning the MSc pro-
gramme, have a look at Nursing Science’s website:
www.umcutrecht.nl/verplegingswetenschap
Postgraduate / Continuing Professional Education
Description
In collaboration with the Education Center of the University Medical
Center Utrecht an annual 5-day course is offered for senior nurses about
reading and critically appraising scientific research (in nursing). The
content of the course is focused on scientific methodological concepts,
finding (by searching in scientific databases as PubMed) reading and
appraising quantitative and qualitative research and, finally, implement-
ing the scientific results in practice.
Course
Course
dates
Number of
participants
% passed
exam
Evaluation
marks
Reading and critical appraisal of scientific
research (in nursing)
21 100 7.5
Education 85
Nutritional Science
There are many misconceptions about the effect of nutrition on health.
Most consumers, patients and doctors are uncertain whether a prudent
diet can prevent diseases and whether clinical nutrition can help cure
disease. The Division of Nutritional Sciences strives to enhance the pro-
fessional competences and the understanding of nutritional problems,
depletion and metabolic needs in relation to disease. An important tar-
get group is the medical students. The Nutrition and Medicine
(‘Voeding in de Geneeskunde’) facultative courses take a collaborative
and interdisciplinary approach to nutritional problems in the clinical
setting.
Bachelor
Description
GNBA221806 – facultative course ‘Voeding in de Geneeskunde’ is a
5-week course for 2nd year bachelors. Learning objectives for the course
are adapted from the ‘Nutrition Curriculum Guide for Training
Physicians Curriculum from the Nutrition Academic Award Programme’
(Pearson TA, Stone EJ, Grundy SM, McBride PE, Van Horn L, Tobin BW;
NAA Collaborative Group. Translation of nutritional sciences into medi-
cal education: the Nutrition Academic Award Programme. Am J Clin
Nutr. 2001 Aug;74(2):164-70.)
Topics include:
- Appraising nutritional information
- Nutritional recommendations for healthy individuals
- Nutritional assessment and nutritional management in disease
- Changing nutritional behavior
- Nutritional Science
86 Annual Report 2008
GNK0708 3 – facultative course ‘Voeding in de Geneeskunde’ is a 4-week
course for 3rd year bachelors. The course consists of (guest) lectures and
group work.
Topics include:
- Methodology: how to read scientific papers about nutrition and health
- Practice: how to assess nutritional status (malnutrition)
- Prevention of chronic diseases
- Therapeutic diets
- Nutritional supplements and functional foods
- Management of treatment side effects
- Management of specialized feeding regimens like tube feedings
- The effect of life style modification
Course
Course
dates
Number of
participants
%
passed
exam
Evaluation
marks
‘Voeding in de Geneeskunde’ -
GNBA221806, year 2 (elective)
Jun 2008 18 100 7.0
‘Voeding in de Geneeskunde’- GNK0708 3 Mar 2008 24 100 6.2
Master’s Degree
Not applicable
Postgraduate / Continuing Professional Education
Not applicable
Education 87
International activities in Education
In education several international activities take place. These range from
inviting international guest lectures and hosting international students,
to organizing educational activities abroad.
Several of the Julius Center’s educational activities are in English and
attract international students, such as the MSc programme in
Epidemiology or the courses that are organized in the EU funded
Interact programme. In postgraduate education, such as the master
classes and congresses organized by the Public Health discipline or the
capita selecta of the MSc programme in Epidemiology, international
guest lecturers are frequently invited to contribute. As well as hosting in
Utrecht, both students and staff also go abroad to teach or be educated.
E.g. students are given the possibility of carrying out an internship
abroad, under the guidance of Julius Staff, with research groups with
whom collaborations exists. The GP vocational training offers an elec-
tive course for medical students on ‘Primary Healthcare’ in Tanzania and
a module on travelers’ advice and imported diseases to GP trainees also
in Tanzania.
Structural educational collaboration still exists with some counterparts.
In 2008 the Julius Center also taught various clinical epidemiology
courses abroad. These countries include Malaysia, Indonesia, Japan,
Canada and the US. The most important international educational
project is currently the European Committee funded project: ‘The Asia-
Europe Clinical Epidemiology and Evidence Based Medicine pro-
gramme’. The Julius Center, Centre for Evidence based medicine Oxford,
the Malaysian Ministry of Health and the University of Malaya Medical
Center (UMMC) in Kuala Lumpur, Malaysia are nurturing a growing
collaboration. (See also ‘Epidemiology, AsiaLink’ in this chapter). The
88 Annual Report 2008
collaboration is based on short, intensive courses on clinical epidemiolo-
gy and evidence-based medicine, delivered by the Julius faculty in col-
laboration with local staff in Kuala Lumpur and Jakarta, the implemen-
tation of an undergraduate module on clinical epidemiology and evi-
dence based medicine in the curriculum of the faculties of Medicine in
both countries and the training of PhD students in clinical epidemiolo-
gy from both countries in the Netherlands. These PhD fellowships will
be supervised by the Julius staff and imbedded into the research lines of
both the UMC Utrecht and the UMMC. During the fellowship, candi-
dates will follow part of their education in the Netherlands, notably in
the Epidemiology prestige master’s programme. Depending on the sub-
ject, research will be carried out at the Julius Center or in their home
country.
The Asia-link project aims to cover three domains: a) Collaborative
research for clinical trials and cohort studies, b) Development and cre-
ation of a regional research infrastructure, c) Expansion of educational
programmes that also focus on the South Asian region.
In order to foster high quality research, a robust research-support
section is needed in both hospitals in which project managers, research
nurses, data managers, computer experts, trial monitors and administra-
tive personnel are based. In cooperation with local staff, the Julius
Center will continue to broaden the programme of short courses on
methods of clinical research. These courses are targeted at medical doc-
tors and clinical investigators in the Southeast Asian region. Eventually,
these courses will be largely conducted by local staff.
The courses in Japan are part of the MSc programme and are part of an
existing collaboration with various Japanese ‘Top’ Universities (Tokai
University, Tokyo University, Keio University, Kitasato University and
The National Cancer Institute). Prof K. Moons has a visiting professor-
Education 89
ship with Tokai and Kitasato University, organizer of these courses. The
courses include a 5-day course in the fall on ‘the principles of clinical
research’, which is followed by a spring course on ‘advanced clinical epi-
demiologic research’. Prof Moons also provides - as a visiting professor -
a one week course at McGill University, Montreal, Canada, on Advanced
Diagnostic Research, and a one week course at VanderBilt University,
Tennessee, US, on ‘advanced clinical research’.
In 2008 the MSc programme signed an intentional agreement with
Mainz University to collaborate in master education in epidemiology by
exchange of both students and staff.
90 Annual Report 2008
Education 91
Patient care
‘The opportunity to put theory into practice means
being challenged’
Simone Kessel, Health Sciences Student
92 Annual Report 2008
Patient Care 93
Nutritional Sciences and Dietetics
The department of Nutritional Sciences and Dietetics consists of two
groups: Nutritional Sciences and Dietetics. Education, research and
quality care consultancy are the core activities of Nutritional Sciences.
Patient care and improving patient care are the core activities of the
Dietetics section.
Nutritional Sciences
Nutritional Sciences aims to improve integration of evidence based
nutritional interventions in medicine. This is achieved by:
- Providing support to health care professionals (dieticians, medical
staff) in the process of developing and implementing evidence-based
nutritional policies and guidelines for several groups of patients.
- Performing (clinical) research on the relation between nutrition and
health (biomedical) and determinants of dietary behavior (social and
behavioral science).
- Providing education to both health care professionals and (para)-
medical students (both HBO and WO).
The department of nutritional sciences works in close collaboration
with the departments of Dietetics and Clinical Epidemiology.
Continuing education for medical and paramedical professionals was
provided by contributions to professional journals and lectures at
national congresses. The department participated in an advisory com-
mittee of the Dutch Health Council on the subject of ‘making healthy
choices, the easiest choices’. The department of dietetics was supported
in evidence-based dietetics (e.g. consultancy function, quality care
projects, journal clubs).
94 Annual Report 2008
For research purposes an update has been made to a food-frequency
questionnaire and efforts have been made to make this questionnaire
available online. After the completion of this project it will be easier to
apply dietary assessment in a research setting. In addition, the depart-
ment supported several applied research projects from the department
of dietetics (see below for details).
For the content of the courses on clinical nutrition and prevention in
the medical curriculum, see the Education section of this report.
Dietetics
The Dietetics section is providing and improving patient care at UMC
Utrecht and at rehabilitation center ‘De Hoogstraat’. The Dietetics sec-
tion is a national leading light in evidence based dietetics and standard-
ized processes for dietetics professionals.
IT developments
The implementation of an electronic dietetics patient file in 2007 was, as
it seems now, the start of a process of innovation and efficiency. The
skills required for working with the file improved rapidly. Not only did
this file replace almost all paper files, during 2008 the section also devel-
oped several improvements to the system and files. Connections with
other electronic files in the UMC Utrecht were also made. Automatic
correspondence to specialists and partners in primary care organiza-
tions, other hospitals and nursing homes were developed too. From the
files, visits are automatically recorded in the UMC Utrecht registration
and financial records.
As a precursor, the section was involved in a pilot involving electronic
order management and the sounding board ‘New electronic hospital
patient file’. The new patient appointment system was implemented and
Patient Care 95
all systems were prepared for the implementation of the BSN (social
security number).
Evidence-based Guidelines
The development of evidence-based guidelines and product descriptions
(short practical guidelines) is still making progress. The guidelines and
product descriptions provided were, as always, topics for concise (stu-
dent) projects. These included amino acids and free fatty acids in
patients with amino acid metabolism disorders, cystic fibrosis and the
use of vitamin supplements, growth and skeleton age in children with
cystic fibrosis, food perception by nurses in the WKZ children’s hospital,
nutritional status in patients with jaw fixation, body composition in
patients pre and post lung transplantation and energy and protein
requirements in surgical patients. In rehabilitation center ‘De Hoog-
straat’ a malnutrition project was started. This was the first time in more
than 20 years of cooperation.
Educational and Scientific Contributions
In 2008 20 students from Wageningen University, VU Health Care and
from the various Dietetics Academies performed student projects and
worked on practical skills.
The dieticians gave several lectures, workshops and poster presentations
for health care professionals in the Netherlands and other European
countries on topics such as Cystic Fibrosis related Diabetes, ketogenic
diet, PKU patient education systems, cardiovascular disease manage-
ment, head and neck cancer. A course on Nutrition Care Process and
Dietetic Diagnosis was developed and presented in cooperation with the
NPI (Dutch paramedic institute) and the Dutch Dietetic Association. In
2008 and 2009 more than 600 Dutch dieticians will be educated in this
subject. Education on several subjects was provided to several specialist
96 Annual Report 2008
nursing groups, the nursing training school in Utrecht and dieticians.
The section also hosted a TODU workshop on regional cooperation in
malnutrition. The dietetic section cooperated in the facultative course
on Nutrition and Medicine.
A few scientific articles were published and several articles and book
chapters are in progress.
Training was provided to the dieticians in the form of external courses,
meetings, and conferences (39 individual activities). These activities
took place in the Netherlands and other European countries.
External International, National and Regional Projects
The Dietetics section contributed to several external projects. The most
important are:
- Chairing and vice-chairing a regional oncology group
- Chairing the national academic dieticians working group
- Member scientific advisory committee of the PKU association
Besides these projects, our staff participated in a wide range of (nation-
al) consultation groups.
Internal Projects
Within the UMC Utrecht, the Dietetics sections participated in the fol-
lowing internal projects and work groups:
- Hosting the UMC Utrecht Clinical Nutrition Advice Board, this
enables us to discuss nutritional problems and new insights in dietetics
in a broader clinical context. Implementation of the ‘screening
malnutrition’ advice, the ongoing tube feeding plan for the UMC
Utrecht and the nearly finished UMC Utrecht food policy plan. A
parenteral feeding project was started.
- screening malnutrition, delivering figures and strategy to the board of
directors
Patient Care 97
- implementation of PKU patient education strategies and patient
education materials
- ‘Better eating’ project in the Wilhelmina children’s hospital
- HOOP study (evidence-based treatment for obese patients)
- participation in clinical multicenter studies (ALS study, PHYTON)
- implementing ERAS
- participation in development and implementation of a new hospital
food distribution project
- European tender for a contract on clinical nutrition and infant
formulas
- pilot JCI quality assessment
- JACY (European quality system in hematology)
Besides these projects, dieticians participated in several internal multi-
disciplinary groups to develop, improve and implement evidence-based
and best practice guidelines
Personnel
In 2008 two persons left the department for personal reasons and one
was dismissed. New personnel filled the vacancies quickly. There were no
formal complaints and there were three patient incident reports.
98 Annual Report 2008
Care provided by the Dietetics in 20081st visit Follow-up visits DME*
Team 1
Outpatients 771 1928 4382
Hospitalized 619 1671 3154
No-show 96 195
Team 2
Outpatients 588 2137 2666
Hospitalized 1396 5158 7443
No-show 31 75
Team 3
Outpatients 1063 3402 5912
Hospitalized 407 849 1815
No-show 20 73
Rehabilitation centre ‘De Hoogstraat’’ 144 404 610
No-show - -
DME *= 30-minute time units
Patient Care 99
Academic Primary Care in Leidsche Rijn
As of January 2004, the Julius Center has been hosting a network for
academic patient care, located in the newly developed Utrecht district of
‘Leidsche Rijn’. In the next few years, Leidsche Rijn will expand to
become a large suburban area, with approximately 80,000 inhabitants.
The Leidsche Rijn Network offers an excellent opportunity for the Julius
Center to fulfill its ambition of providing academic health care services
in primary care. This involves high quality patient care, closely integrat-
ed with (vocational) training and research. In order to facilitate this,
training facilities will be incorporated into the health centers at Leidsche
Rijn, enabling on-location training of medical students, general practi-
tioners and other health care professionals. Electronic recording of all
aspects of medical care as well as dedicated support staff will provide the
basis for an excellent research environment in the Leidsche Rijn health
centers. Most new inhabitants of Leidsche Rijn are already participating
in the Leidsche Rijn Health project (LRGP), which records their basic
health characteristics and offers instant medical assessments. In future,
this health profile will be related to updated primary medical care data
at the health centers. Medical follow-up of the Leidsche Rijn population
combined with academic research will enable us to develop evidence-
based multidisciplinary patient-centered health care programmes.
Julius Health Centers
One of the ambitions of the Julius Center is to create an academic envi-
ronment in primary care, in which research and medical education are
combined with high quality, innovative patient care. In order to realize
this ambition the Julius Center has been coordinating the development
of the primary health facilities in Leidsche Rijn, the VINEX area of
100 Annual Report 2008
Utrecht since 2004. In 2008, primary care services were provided to
more than 20.000 inhabitants from four centers of the Julius Health
Centers. In order to provide these services, the Julius Health Centers
employ twenty general practitioners, ten physiotherapists and auxiliary
nursing and administrative staff. In 2008, the centers entered the next
phase in their academic development.
The key features and prerequisites of the next phase of the academic
development and the time frame to develop an integrated research/edu-
cation/patient care environment are described in a detailed development
plan. This process requires close cooperation with primary care partners,
hospital colleagues, patients and other stakeholders. The development
plan, which covers a period of five years, was adopted by the staff and
management team of the Julius Center at the end of 2007.
In 2008 the first part of this next step in the academic development in
the Julius Health Centers was implemented, with the assignment and
training of academic staff for four different clinical fields (cardiovascular
disease, COPD, mental health and diabetes) as well as for academic edu-
cation. The academic patient care programmes that they developed will
be further integrated in daily clinical care from 2009 onwards. In 2009
and 2010 the programme will be extended to eight other clinical fields,
resulting in full implementation of the academic infrastructure in 2012.
Patient Care 101
Unit Health Care Innovations
The focus of the Unit is the study of; i) integrated care and disease man-
agement and ii) emergency services. The first theme consists of three sub
themes: a) the epidemiology of chronic care b)The evaluation of inno-
vative interventions and c) the validation of assessment instruments and
procedures to select patients with a chronic condition for early interven-
tions. The emergency services theme has three comparable sub themes:
- the epidemiology of emergency services provided by GP cooperatives,
emergency departments and ambulance services
- evaluation of innovative emergency interventions and
- validation of assessment instruments and procedures to triage patient
with acute needs.
In 2008, the Unit grew from 17 fte professional staff to 25. They profiled
themselves on the two mentioned themes. Six research grants were
acquired from scientific funds, social funds, and Ministry of Health,
social insurance agencies and health care providers. Ten (2008:6) con-
gresses with a total of 1500 participants and seven (2007:4) courses with
28 participants took place. Two PhD theses, eleven scientific publications
and many reports were published. The group was repeatedly asked to
give guest lectures on scientific and professional congresses. In 2008 the
Unit had a positive financial result.
The Unit of Health Care Innovation participated structurally in the
European Health Leaders Programme, which is a cooperative of five uni-
versities: Utrecht, Budapest, Stockholm, Berlin and Durham (UK). This
course last for eighteen days. The Julius Center was responsible for the
theme of health care innovations and this received a very positive evalu-
ation.
102 Annual Report 2008
In October, the Julius Center’s Unit for Health Care Innovations orga-
nized a study trip to Kaiser Permanente in Denver (Colorado). The pur-
pose of the trip was set out beforehand and was to acquire know-how on
1 integrated health care (integration of primary health care and
hospital care
2 cooperation between health care providers (= Permanente)
3 design and functioning advances Health Information System and
4 emphasis on preventive interventions.
The study visit offered many eye-openers to the study trip comprising a
group of 30 experienced health care professionals and managers. The
ideas in the trip contributed strongly to the debate in Holland about
cooperation and combined hospitals and Insurance companies.
Patient Care 103
104 Annual Report 2008
Education 105
Operational support
‘Education is essential, to create awareness for the
quality standards of Good Clinical Practice!’
Mariska Hafkamp, Quality Manager,
Research Quality Assurance Organization
106 Annual Report 2008
Operational Support 107
Management Support
The Julius Center’s core activities of research, education and patient care
are supported by a number of services. Management is supported by a
central finance department, a personnel & organization (P&O) depart-
ment and an ICT department. The finance department handles all con-
tracts and other financial matters. The Julius Center is highly dependent
on external funding, such as the European Counsel funds or Dutch
research funds, such as ZonMw. Because the administration of these
funds is very complex, the center devoted much attention in 2008 to
professionalization and staff development. This professionalization has
taken the shape of a renewed planning and control cycle which makes it
possible to manage all financial aspects of the organization. The key-
word in this planning is ‘prognostication’. The P&O department deals
with management development, vacancies and all procedural matters
involving employment. The ICT Department is responsible for the
development and maintenance of an infrastructure that supports both
office automation and scientific research. It provides user support and
Internet development services. The Julius Center website was completely
renewed and updated in 2008.
108 Annual Report 2008
From CTSU to Julius Clinical Research and Research Support
In the first half of 2008 the Clinical Trial Services unit (CTSU) was
active as it has been in previous years. This included project manage-
ment, monitoring, an outpatient research clinic, quality assurance, help-
desk for questions regarding quality issues and providing a technical
infrastructure for the collection, processing and analysis of data. The
success of the clinical trial services (CTSU) required the repositioning of
these activities. Therefore, in 2008, the Julius Center started to transfer
part of the clinical trial activities to Julius Clinical Research (JCR), an
independent Academic Clinical Research Organization. JCR delivers
high quality clinical trial services to the pharmaceutical industry and the
academic society. at the end of 2008 the process of transferring project
management and clinical monitoring staff to JCR was also started. The
formal transition of the staff from the former CTSU to JCR will take
place in 2009. Research support services that will stay at the Julius
Center include the outpatient research clinic, data management, quality
assurance and the vascular imaging center.
The Julius Center collaborates with institutes from Sydney, Australia and
Minneapolis, USA within the Academic Alliance for Clinical Trials in
sharing knowledge and experience about performing clinical trials and
the use and improvement of quality systems.
Clinical Trial and Services Unit (CTSU)
The CTSU existed until the fall of 2008. CTSU services were available for
internal (Julius Center) and external sponsors. External sponsors could
be other divisions of the UMC Utrecht pharmaceutical and food compa-
nies or other scientific institutes (RIVM, TNO, NVI). The CTSU has
Operational Support 109
been certified in line with ISO9001:2000 since January 1st, 2005 and has
prolonged this certification in 2008 for another 3 years.
CTSU services included:
- Project Management including the organization, execution and
monitoring of clinical trials from initial design to final publication
- Clinical trial coordination
- Site monitoring
- Site management
- Data management
- End-point adjudication management
- Adverse event reporting
- Clinical Trial Monitoring of mono and multi-center trials based in The
Netherlands and other European countries
- Research Clinic: an out-patient research center fully equipped with
state of the art clinical and diagnostic facilities for carrying out clinical
trials
- Vascular Imaging Center: a center of expertise in vascular ultrasound
imaging and retinal vascular measurements
- Data Management utilizing Teleform® and Research Online
- Quality Assurance and Control in accordance with ICH-GCP
Guidelines and ISO 9001:2000 certification
About 60 persons were working at CTSU, including 10 CRA’s based at
home and in other European countries. They were involved in about 40
different projects.
At the end of 2008 the CTSU services management and clinical moni-
toring project started to become part of Julius Clinical Research. The
110 Annual Report 2008
other services stayed in the Julius Center and are now called Research
Support.
Research Support
Research clinic
The research clinic is an out-patient research center fully equipped with
state of the art clinical and diagnostic facilities for carrying out clinical
trials in accordance with Good Clinical Practice guidelines. In 2008 the
research clinic was involved in 25 studies. Four of them were new inter-
vention studies. For some other studies the participation was very low.
About 15 persons were working for the research clinic, including
research physicians, research nurses, administrative trial assistants and
project managers. The research clinic has its own database with about
4000 “healthy” volunteers who are interested in taking part as a partici-
pant in a study.
Data Management
The data management department provides high quality data manage-
ment, according to GCP requirements, to facilitate the collection, pro-
cessing, management and analysis of epidemiological data. These servic-
es are available for a broad range of clients: the Julius Center researchers
and research clinic, researchers of other UMC Utrecht divisions and
external parties.
At the end of 2008 there were about 90 ongoing projects in the depart-
ment. Among these projects were clinical trials, observational studies,
cohorts and management information applications.
In 2008 34 new projects started:
- In 17 projects, either paper based (4) or electronic (13), CRF’s were
developed to support data collection for clinical studies. Major studies
Operational Support 111
are: MOSAR (WP3, WP4 and WP5), CHAMP, LITRA, IC delirium,
SportCor, Topfit, Panacea and Tiki.
- In 17 projects specific databases and applications were designed to
support cohorts, data entry processes, study participant management,
study specific logistics or to gather management information. Major
projects are Isala heart surgery database, Capita, IRIS, MIS onderwijs
and Mondriaan.
- Furthermore, online randomization was implemented for an
additional 8 studies.
About 20 projects were closed in 2008 and at the end of the year the
department had about 15 prospects.
Besides providing data management for studies, courses were given to
researchers on best practices in SPSS. Furthermore, data management
participated within the BROK course to provide training on GCP issues
within data management processes.
This year, the electronic data capture system ‘Research Online’ was fur-
ther developed by our department and extensively used for clinical stud-
ies (13 new studies were implemented). The system, which was initially
developed in 2006, is now being used successfully within 19 studies.
Among these studies are 3 studies granted by the European Commission
(GRACE, MOSAR and CHAMP). Data collection for these studies takes
place within 20 countries. The department uses Research Online to facil-
itate data management in about 75% of all new clinical studies.
The data management department consisted of 13.6 FTEs (16 employees
in absolute numbers).
112 Annual Report 2008
Quality Assurance
The Julius Center provides services in clinical research that need to be
compliant with ICH-GCP and other applicable guidelines and legisla-
tion. The Julius Center is responsible for the Quality Assurance System
for clinical drug trials performed in the UMC Utrecht (Bureau
Kwaliteitsborging Onderzoek - BKO). It is staffed by Quality Managers
and experienced Project Managers from the Julius Center for Health
Sciences and Primary Care.
The Julius Center’s quality assurance managers provide support and
advice in organizational and regulatory aspects of clinical research and
also supervise and verify adherence to the quality system by staff from
the Julius Center. This is achieved by:
- Training CTSU staff
- Internal audits
- Regulatory advice and support (helpdesk)
- Participation in study teams
- Development and improvement of procedures and tools
- Analysis of performance measurements
Activities related to clinical drug trials include compulsory quality intake
checks before starting the study and helpdesk services for questions
regarding quality issues, training and audits. Since its inception in July
2006, 253 intakes have been performed over 2.5 years. The 2.5 year eval-
uation showed positive feedback from investigators and a general
improvement in quality consciousness. The BKO was audited by an
independent auditor in November 2008. The auditor was very positive
about the UMC Utrecht’s initiative to set up such a Quality System at
the UMC Utrecht. In order to assure the best quality of clinical research
overall at the UMC Utrecht, one of the recommendations from the audi-
Operational Support 113
tor was to extend the BKO’s mission to cover all WMO related studies,
including studies on medical devices and combined medical device/
medicinal products. Among other things, this will be the recommenda-
tion provided to the Hospital Board of Directors.
Besides BKO GCP training, the Julius Center introduced a 4 day course
in the UMC Utrecht specifically aimed at investigators performing clini-
cal trials: BROK-Basiscursus Regelgeving en Organisatie voor Klinische
onderzoekers. The idea to set up such a specific course was introduced
by the Dutch federation of University Hospitals (Nederlandse Federatie
van Universitaire Medische Centra-NFU). The course was run twice in
2008 and was well evaluated by the participants. The BROK was exam-
ined digitally and scored above national average in the UMC Utrecht.
The course will be continued in 2009.
Vascular Imaging Center
The VIC is a core laboratory facility that supports a range of vascular
measurements, with the emphasis on ultrasound techniques. Since the
start of the VIC in 1997, we have supported a large number of etiologic,
prognostic and therapeutic vascular projects among asymptomatic and
symptomatic men and women from the general population, the outpa-
tient clinic and the hospital using non-invasive techniques.
The activities of the VIC comprise development of measurement proto-
cols, advice on equipment, performance of actual measurements, train-
ing on site and certification, continuous quality assurance and quality
control programmes during the study, quantitative QC/QA, reading of
stored images, data management, statistical analyses and scientific
reporting. All activities are performed according to GCP guidelines, and
114 Annual Report 2008
Operational Support 115
documented ‘standard operational procedures’ are available for each
procedure at the VIC, including IT procedures.
For all supported measurements, the VIC provides training and certifi-
cation of technicians for the protocols involved. Training can be given in
Utrecht and on-site using the equipment at the participating center.
Since the start of the VIC in 1997, we have performed more than 20,000
vascular measurements in approximately 6,500 subjects.
Julius Clinical Research BV
July 2008 saw the birth of Julius Clinical Research BV, the successor to
the Clinical Trial Services Unit of the Julius Center.
Julius Clinical Research (www.juliusclinical.com) profiles itself as an
academic CRO (ARO) dedicated to delivering high quality clinical trial
services both to the pharmaceutical industry and to the academic soci-
ety. Its close ties with the UMC Utrecht and the Julius Center enable
Julius Clinical Research to add science to its industry standard processes
that find their way to the international scientific journals such as smart
trial design, independent statistical analysis, quality report writing and
scientific publications. Moreover, its academic roots give Julius Clinical
Research access to an international network of excellent investigators
‘Julius Clinical Research is an ARO which stands for Academic Research Organisation.
The word Academic is not something for a glossy marketing brochure but an essen-
tial aspect of who we are. At Julius Clinical Research we look forward to collabora-
ting with the Julius Center and UMC Utrecht on academic clinical research projects.’
Peter Schoevers, CEO of Julius Clinical Research BV
116 Annual Report 2008
and hospitals in the relevant therapeutic areas and this provides an
attractive proposition, particularly in relation to the global pharmaceuti-
cal industry.
In 2008, contract negotiations were started between the UMC Utrecht
and Wyeth Pharmaceuticals for the execution of the CAPiTA trial, a
mega-trial in the area of infectious diseases, designed to evaluate the
efficacy of a new vaccine against pneumococcal infections in 85,000
elderly subjects, for which the recruitment phase was scheduled to begin
in the Netherlands during the flu vaccination period of 2008. Although
it was the intention that the establishment of the new company would
be completed well before the start of the CAPiTA trial, by the time Julius
Clinical Research was formally established, the contract with Wyeth had
already been signed and preparations for CAPiTA had already been
started by the Clinical Trial Services Unit of the Julius Center. In view of
the large project organization that had to be established for the CAPiTA
trial in a limited amount of time, it was decided to postpone the transfer
of the CTSU staff to Julius Clinical Research until early 2009, in order
not to complicate the work for CAPiTA. A number of CTSU key staff
members were in-sourced from the Julius Center to fulfill important
project management and clinical trial support activities for CAPiTA. As
a result, although the CTSU staff had not yet been formally transferred
to Julius Clinical Research, a natural cohabitation between CTSU and
Julius Clinical Research came into being. This will provide a sound basis
for a smooth transition in 2009.
For the first months of its existence, Julius Clinical Research has very
much been a CAPiTA project organization only. All attention and energy
has been dedicated to preparing for the big wave of vaccinations in
October and November. While the number of employees on the payroll
was only small, the number of temporary professionals working on
CAPiTA under the auspices of Julius Clinical Research well exceeded 800
Operational Support 117
during the peak of the first vaccination round. By the end of November,
almost 30,000 subjects had been recruited and vaccinated. In close con-
sultation with the sponsor, it was decided to set up a second vaccination
round in 2009, with the aim of completing recruitment before the start
of the 2009 flu vaccination period.
In spite of the focus on the CAPiTA study, business development activi-
ties were actively started and this led to some interesting and promising
leads. At the close of 2008, prospects for contracting a large international
study in the cardio-vascular area and a national study in the area of
infectious diseases are bright. In addition, a number of investigator initi-
ated studies in the areas of mental disease and public health are under
preparation.
The year 2009 will bring some challenges for Julius Clinical Research.
The recruitment phase of the CAPiTA study must be completed success-
fully before the fall of 2009. The transition of the CTSU staff to Julius
Clinical Research will take place in the second quarter. For some key
areas of our activities, recruitment of new staff will be of vital impor-
tance. Two large projects that are being discussed with pharmaceutical
companies need to be translated into actual contracts.
For Julius Clinical Research’s international aspirations, it is essential that
the collaboration in the Academic Alliance for Clinical Trials
( www. academicalliance.com) is further intensified and expanded.
Discussions with the other partners in the AACT are propelled by the
prospect of another large international collaborative project.
We are looking towards the future at Julius Clinical Research with confi-
dence and excitement.
118 Annual Report 2008
Personnel and finances
‘If you think education is expensive, try ignorance’
Derek Bok, President, Harvard University 1971-1991
Marco Perdon,
Operational Support, Educational Finances
120 Annual Report 2008
Personnel and finances 121
Personnel, Figures
Absolute numbersScientific Support Care TOTAL
Male 74 32 1 107
Female 165 58 25 248
TOTAL 239 90 26 355
FTE
Male 47.35 28.96 0.67 76.97
Female 110.13 39.89 19.73 169.75
TOTAL 157.47 68.85 20.40 246.72
Average FTE
Male 0.64 0.91 0.67 0.72
Female 0.67 0.69 0.79 0.68
TOTAL 0.66 0.76 0.78 0.69
122 Annual Report 2008
Personnel, Listing 2008* Adjunct faculty (in Dutch ‘Nul-aanstelling’)
Management
Management team
Graaf, Y. van der, Prof. MD, PhD
Grobbee, D.E., Prof. MD, PhD
Hoes, A.W., Prof. MD, PhD
Starre, M. van der, MSc
(until August 2008
Lieshout, B.C. van, MSc (a.i.)
Staff
Kluijtmans, M., PhD
Secretariat
Braun, H.A.
Hartog, M.A. den
Kuijer-Eck, M.C.E. van
Kusters-Ritman, J.C.
Vries, G. de
Clinical Epidemiology
Abeelen, A. van, MSc*
Algra, A., Prof. MD, PhD
Ameijden, E.J.C. van, PhD*
Appelman, A.P.A., MD, PhD
Arts, I., MSc*
Asselt, K.M. van, MD
Baan, F.H. van der
Baart, A.M.*
Baas, A.F., PhD*
Bakker, L.T.
Bauer, F., MSc
Bax, L., MD*
Beulens, J.W.J., PhD
Beus, M.F. de, MD
Bhoo Pathy, N., MD*
Bliek, J.B.
Blom, S.S.A.H.
Bonten, M.J.M., Prof. MD, PhD
Boonacker, C.W.B., MSc
Bootsma, M.C.J., PhD
Bots, M.L., MD, PhD
Bouwmeester, W., BSc
Brouwer, B.G., MSc*
Brussee, J.E., PhD
Dasrath, U.
Dekker, M.S.*
Derde, L.P.G., MSc
Dieren, S. van, MSc
Dogan, S., MSc
Dool, C. van den, MSc
Drijvers, J.J.M.M.
Duijnhoven, F.J.B. van, MSc
Edlinger, M., MSc
Elbers, C.C., MSc
Personnel and finances 123
Elias, S.G., PhD
Ettema, R.G.A.*
Feenstra, A.
Fischer, K., MD, PhD
Fraza, A.
Gast, G.C.M., MSc
Geerlings, M.I., PhD
Geerts, C.C., MD
Gerritsen, L., MSc
Gils, C.H. van, PhD
Gondrie, M.J.A.
Gorcum, A.N. van
Gourieva, T.V.
Greving, J.P. PhD
Grigoryan, L., MD, PhD
Groeneveld, J. PhD
Groenwold, R.H.H., MSc
Grool, A., MD
Groot, J.A.H. de, MSc
Groot, M.C.H. de*
Hady, M.S.A.*
Harimurti, K.H.*
Heijden, G.J.M.G. van der, PhD
Hendrix, A*
Hertogh, E., MSc
Herve, H.*
Hoorn-van Kempen, M.H. van der
Hopman, M.C.
Huijts, S., MD
Idris, B.I.*
Janssen, K.J.M., PhD
Kamphuis, M.H., MSc*
Knol, M.J., MSc
Knoops, A.J.G., MSc
Kretzschmar, M., PhD
Kurniati, N., MD*
Laan, W., PhD
Lokate, A.J.M., MSc
Lucas, Y.M.
May, A.M., PhD
Melsen, W.G., MSc*
Metselaar-van den Bos, J.J.
Molenaar, E.A.,PhD
Monninkhof, E.M., PhD
Moons, K.G.M., Prof. PhD
Mosterd, A., MD*
Nijdam, M.E., MSc
Noord, P.A.H. van, MD, PhD
Onland-Moret, N.C., PhD
Peelen, L.M., MSc
Peeters, P.H.M., Prof. MD, PhD
Perales, L.E.M.
Peters, H.G.M., MD*
Pijl, A.G.
Plantinga, Y., PhD
Roest, S.J.A.M.M.
Rovers, M.M., PhD
Schilder, A.G.M., PhD*
Schouw, Y.T. van der, Prof. PhD
Sluijs, I.S., MSc
124 Annual Report 2008
Smit, H.A., PhD*
Soedamah-Muthu, S.S., MD, PhD
Spoel, O.P. van der, MSc*
Stefansdottir, G.
Stegenga, B.T., MSc
Stolk, R.P., Prof. MD, PhD*
Stolwijk, A.
Tjang, Y.S.*
Toll, D.B., MSc
Trapman, J.P., MSc
Uijl, I.E.M. den, MSc
Uijl, S.G., PhD
Uiterwaal, C.S.P.M., MD, PhD
Vaartjes, C.H., MSc
Velthuis, M.*
Vergouwe, Y., PhD
Verheugt, C.L., MD*
Verheus, M., MSc
Verkooijen, H.M., MD
Vermeulen, R.C.H., PhD*
Vlek, A.L.M., MD*
Vrieling, A., PhD
Wallinga, J., PhD
Warnier, M.J., MD*
Weerd, M. de, MSc
Welsing, P.M.J., PhD
Werkhoven, H. van
Westendorp, G.W.
Winden, A.W.J. van, MSc
Zafarmand, M.H., MD, PhD*
Secretariat
Fraza, A.
Haks-Schoonderwoerd, T.L.T.M.
Houthuysen, J.M.
Knegt, M. de
Koopmans, A.
Meegdes-Kuiperij, H.
Noppen-Pinkaarts, D.J.W. van
Paltan, S.
Wesselink-van Meerten, I.E.
General Practice
Appelman, C.L.M., MD, PhD
Avendonk, M.J.P. van, MD
Balen, F.A.M. van, MD, PhD*
Bartelink, M.E.L., MD, PhD
Beem, E.E., PhD
Bij, S. van der
Bijkerk, C.J.*
Bijkerk, C.J., PhD*
Bont, J., MD*
Bosman, M., MSc
Bossenbroek, J.G.
Both, L
Broekhuizen, B.D.L.
Bruggen, J.A.R. van, MSc
Bruin, M.L. de, MSc*
Bruins Slot, M.H.E., MD*
Cleveringa, F.G.W., MD
Coenen, V., MD
Personnel and finances 125
Decanniere, A.B.A.
Donk, M. van den, PhD
Du dok van Heel-Sakkers, P.M.A.,
MSc
Duijn, H.J. van, PhD
Eenige, M.M. van, MSc
Engelsen, C. den, MD*
Essen, G.A. van, MD, PhD
Geersing, G.J., MD
Gorter, K.J., MD, PhD
Graaff, M.E.
Hak, E., MD, PhD
Hart, H.E., MD, PhD
Helsper, C.W., MD*
Hendriks, A., MSc*
Hoekstra, J.F., MSc*
Jacobs, P.C.A., MD*
Janssen, P.G.H., MD
Kelder, J.C., MSc*
Keyer, H.*
Kreuger, M.J.O.
Kuijper, E.C.
Kuyvenhoven, M.M., PhD
Looijmans-van den Akker, I., MD*
Mennink, M.
Mol, S.S.L., PhD
Mujakovic, S., MSc
Numans, M.E., MD, PhD
Opstelten, W., MD*
Oudega, R., MD, PhD
Oudejans-Mooijaart, I., MD*
Pijpers, E.J.
Raat, A.M.C., MD
Rambharose, V.R.
Raupp, G.E.M.
Rikken, L.H.M., MD
Rutten, F.H., MD, PhD
Rutten, G.E.H.M., Prof. MD, PhD.
Sachs, A.P.E., MD, PhD
Scheele, E.A.E., MSc
Scheltens, T.
Siccama, R., MD
Smeets, H.M., MD
Velden, A.W. van der, PhD
Venekamp, R.P., MD*
Verheij, Th.J.M., Prof. MD, PhD
Visser, A.C.E.
Vo orst Vader-Stikkel, M.L.C. van,
MSc
Vreugdenhil, H.A.E., PhD
Vugt, S.F. van, MD
Wermeling, P.R.
Wit, N.J. de, MD, PhD
Secretariat
Blijleven, E.M.
Dijk-Okla, M.K. van, MA
Laurens, I.C.
Weel-van der Heijden, A.A.H.M.
126 Annual Report 2008
General Practice Vocational
Training
Albert, M.C.G.A., MSc
Barels, I.H., MD
Beek, C. van, MD
Belgraver, A., MD
Boer, L.J. de, MD, PhD
Bruggen, E. van, MSc
Cingel, M.I. van der, MSc
Dagnelie, C.F., MD, PhD
Djajadiningrat, M., MSc
Dool-Mulder, M.S. van den, MD
Feijen, M.K.E., MSc, MD
Filippo, M., MD
Graaf, P. de, MD
Grunt, N.G. de, MD
Halteren, M.M. van, MD
Hemert, M.M.H.M. van, MD
Hendrickx, E.F.H.M., MD
Hirsch, R., MD
Jagt, E.J. van der, MSc
Konings, J.E., MD
Kraan, W. van der, MD
Kruithof, P.J., MSc
Ledoux, M.E.V., MD
Leeuwen, A.J. van, MSc
Lennep-Sanders, A.R.J. van, MD
Maaijen, J., MD, PhD
Maillé, A.R., MSc, PhD
Mathot, M.A., MD
Mutsaets, E.J.M., MD
Pieters, H.M., MD, PhD
Quartero, A.O., MD, PhD
Rompelman, S.E.C., MD
Schouten, M., MSc
Stempvoort, W.M. van, MD
Schellekens, M.J.F.M., MD
Terluin, M., MD
Tjin-a-Ton, J., MD
Truijens, L., MD
Vermeulen, M.I., MD
Vernooy, C., MSc
Vooren, R.C. van de, MD
Vossen, S., MSc
Wilt, M.J.G. de, MSc
Zwart, D.L.M., MD
Zwart, S., MD, PhD
Secretariat
Bogaards-Godschalk, M.
Groothedde-Zeilstra, R.
Hoeven-van Ingen, S. van den
Ho even-van Vriesland, I.A. van
den
Honk, S.M. van
Jordan-Carels, H.M.
Mertens, W.
Nusse, C., MSc
Wolf-Verschuure, T.W.P.M.
Zwijnenburg, M.
Personnel and finances 127
Leidsche Rijn, Julius Health Care
Centers
Damme, R.A.E. van, MSc
Public Health / MTA / Medical
Ethics
Public Health/ Unit Health Care
Innovations
Althuis, E.I. van
Belkadi, H., MSc
Berk, M.B., MSc
Biesaart, M.C.I.H., MSc
Boot, J.M.D., MSc*
Bos, N., MSc
Bours, P.H.A., PhD
Derckx, V.L., MSc
Haneveld, R.W., PHS, MPH*
Hermsen, L.A.H., MSc
Leeuw, J.R.J. de, PhD
Ros, W.J.G., PhD
Schrijvers, A.J.P., Prof., PhD
Simkens, A.B.M., MSc
Smit-Kam, M.A.
Stel, H.F. van, PhD
Sturms, L.M., PhD
Swaans, I.J.E.M., MD
Touwen, I.D.
Trappenburg, J.C.A., MSc
Urbanus-van Laar, J.J.N., PhD
Veenendaal, L.J. van, MSc
Vliet, M.J.H. van, MSc
Weert-van Oene, G.H. de, PhD
Wulp, I. van der, MSc
MTA/KEA
Borkent-Raven, B.A., MSc
Buskens, E., MD, PhD*
Heeg, B.M.S., MSc*
Hout, B.A. van, Prof. PhD
Janssen, M.P., MSc
Koffijberg, H., PhD
Mangen, M., PhD
Poel, C.L. van der, PhD*
Ramwadhdoebe, S., MSc
Verschuuren, M., PhD
Wit, G.A. de, PhD
Medical Ethics
Bernabe, R., MA
Bredenoord, A.L., MA
Delden, J.J.M. van, Prof. MD, PhD
Eikelboom, J.I., MD
Graaf-Verhave, R. van der, MSc
Huisman, F.G., Prof. PhD
Stuifbergen, M., MSc*
Thiel, G.J.M.W. van, MSc
Secretariat
Bruin, C.E.T. de
Esser, A.
128 Annual Report 2008
Hageman-Raatgever, G.M.C.
Meegdes-Kuiperij, H.
Munsterman, J.
Sies, C.P.
Straaten, M.C. van
Nursing Science
Berg, M.J. van den, MSc
Bijl, J.J. van der, PhD
Boer, F. de, PhD
Fluttert, F.A.J., MSc
Gamel, C.J., PhD
Goverde, C.A.M., MSc
Hooft-Leemans, G. van der, MSc
Horenberg, A.H., MSc
Kars, M.C., MSc
Korte, M.C. de, MSc
Linge, R.H. van, PhD
Meijel, B.K.G. van, PhD*
Moes, H., MSc
Oosterom, M., MSc
Ros, W.J.G., PhD
Schoonhoven-Noorland, L., PhD*
Tuijtel, G.H.
Secretariat
Dekker, M.S.*
Garden, B. van
Biostatistics
Kruitwagen, C.L.J.J., MSc
Martens, E.P., PhD
Pestman, W.R., PhD
Schipper, M., PhD
Stellato, R.K., MSc
Tweel, I. van der, PhD
Westers, P., PhD
Secretariat
Agterhuis, E.
Nutritional Science/Dietetics
Alst, S.C.G. van, MSc RD
Broekman-Peters, N., RD
Bruin, M. de, RD
Carbasius Weber, E.C., RD
Halen-Kemp, K. van, RD
Harten, J.N.N. van, RD
Heest-Cooman, P.D. van, RD
Hiemstra, G.K., RD
Hoekstra, T., PhD
Hollander-Kraaijeveld, F.M., RD
Hurk, Th.A.M. van den, RD
Iestra, J.A., PhD
Jongh-Kampherbeek, E.H. de, RD
Lamarche, N., RD
Leermakers-Vermeer, J.M.P., RD
Los, M., RD
Losper, S.C., RD
Personnel and finances 129
Luyt, J.W.H. van der, RD
Michelsen-Huisman, A.D., RD
Renken-Terhaerdt, J.W.M., RD
Roos, N.M. de, PhD
Runia, S., RD
Schregardus, D., RD
Schreurs, J.C.M., RD
Somer, M., RD
Steenhagen, E., RD
Timmer, C., MSc, RD
Woestenenk, J.W., MSc, RD
Secretariat
Donker-Spronk, M.
Gil, A.
Maarseveen-Hendriks, J.M. van
Clinical Trial Services Unit
Bak, A.A.A., MD, PhD
Bobbink, W.G., PhD
Bolkenbaas, M. MD*
Brink, J.J. van de
Brugman, C.C.W., MSc
Caspers, E.
Dijk, M.P.M., MSc
Dongen, A. van
Eck, J.W.M. van, MSc
Ehrencron, M.C.T.
Groot, C.G.E.M.
Haars, G., PhD
Hafkamp, M.C., MSc
Hemert, G.B. van
Holleman, P.
Izeboud, L.D.
Kowal, I.
Kuiper, M.W., MSc
Leeuw, M. de, MSc
Meer-Poelwijk, M.J. van der
Meijers, G.E.P.M.
Menninga, K.E.
Molen-Dokter, J. van der
Mooiweer-Boogaerdt, D.B.
Nijssen, K.M.
Noordzij-van Willligen, J.J.
Ophorst-den Besten, H.A.
Pas, C.B.G.H. van der, MSc
Ram, E.A.M.
Scholten, M.J.G.
Sies, B.W.P.M.
Sikking, I.E.M.
Stern-vd Heuvel, J.J.M. van der
Stooker-Brouwer, J.A.G.
Suiker, A.M.H., MSc
Tims-Polderman, C.A.J.
Vendrig, L.
Vissers, I
Vlist, L. van der
Weerd, T.C. van der
Wijnia-Lemstra, E.A., MSc
Williamson, K., PhD*
130 Annual Report 2008
Winter, R.F.J. de*
Wisse, H.
Zuidema, J.A., MD
Zwart, L.M.
Secretariat
Eden, P.M. van
Kubicarova, M.
Linnebank-Hillebrand, N.
Maekelbergh, C.E.
Verreussel, M.H.G.H.
Wilken, R.C.M.
Data Management
Abbel, O.
Beurden, M.M. van
Boekema-Bakker, N.
Dijker, B.D., MSc
Doest, D. ter
Geerts, A.C., MSc
Haak-van Mourik, M.L. van den
Hemert, S.J.M. van
Heuveling, L.M.
Leus, F.
Lom, R. van
Maaskant, J.W.
Petersen, R.B. van, MSc
Schotsman, J.J., MSc
Slotboom, B.J.
Spithoven-van Leeuwen, E.H.J.
Veen, R.E.R., MSc
Zuithoff, N.P.A., MSc
Zwerver, J.
Management Support
Finances and Facilities
Baars, W.D.
Bekkers, M.H., MSc
Booden, K.
Dettingmeijer, R.*
Horstink, G.H.M.
Kesteren, H.G.B van
Keurs, H. ter
Meijering, G.*
Perdon, M.
Plomp, E.P.
Rietveld-Ernst, M.
Rijn, C. van
Schenk, S.
HRM
Molenaar, J.J.
Schaik, A.E.L. van
Secretariat
Blom K.
ICT
Bouabdellaoui-Abahai, S.
Dijk, P.H. van
Personnel and finances 131
Frens, H.C.
Harkema, J.C.
Jonge, J. de
Nelissen, R.
Vos, M.
Communication
Avezaath, M.E. van*
Werff, M. van der
Wolfslag, G.*
132 Annual Report 2008
Financial Report
Financial Overview 2008
Costs Income
UMC Personnel Science € 4,930,081 -€ 1,732,310
Care € 1,042,827 -€ 49,298
Support € 1,543,201 -€ 1,016,988
GPVT € 2,776,475 -€ 3,315,247
Project SMART € 339,715 -€ 302,549
Julius Healthcare centre € 325,097 -€ 318,874
Running costs Science € 1,011,067
Care € 11,448
Support € 211,009
GPVT € 501,024
Project SMART € 70,114
Julius Healthcare centre € 13,548
Investments € 196,638
UMC Budget -€ 6,236,979
Total € 12,972,245 -€ 12,972,244
Projects Personnel
Commercial € 4,109,075
Non-commercial € 1,388,834
Running costs Commercial € 1,593,584
Non-commercial € 82,441
External budget -€ 7,173,933
Total € 7,173,933 -€ 7,173,933
Grand total € 20,146,177 -€ 20,146,177
Personnel and finances 133
Organizations and Companies Providing Funding
ADIR
AGIS Zorgverzekeringen nv
Akzo Nobel nv
Astmafonds
Astra Zeneca
Bayer Health Care
Bowling Pfizer
Centrum Maliebaan
College van Zorgverzekeraars
Danone Research bv
Diabetes Fonds
Districts Huisartsen Vereniging
DGV Nederlands Instituut voor Verantwoord Medicijngebruik
European Union
Eli Lilly Nederland bv
Gemeente Amsterdam
George Institute for International Health
GlaxoSmithKline
Imperial College London
Internationale Stichting Alzheimer Onderzoek
Koningin Wilhelminafonds (Nederlandse Kankerbestrijding)
Lipid Nutrition bv
Landelijk Centrum Verpleging & Verzorging
Landelijke Stichting Beheer Kruiswerk
Medpace
Merck Sharp en Dohme
Ministerie van Volksgezondheid , Welzijn en Sport
Nederlandse Hartstichting
134 Annual Report 2008
Nederlandse Organisatie voor gezondheidsonderzoek en zorginnovatie
(ZonMW)
Nederlandse Vaccin Instituut
Novartis Pharma bv
Novo Nordisk Farma bv
Nutricia
NWO
Organon Nederland bv
Pfizer
Pharmanet
RIVM
Sanofi-Aventis
Sanquin
SBOH
Servier
Schering Plough
Sticares
Stichting centraal fonds Reserves Voormalig Vrijwillige
Ziekenfondsverzekering
Stichting Koningsheide
Stichting RIPAG
Stichting Vascular Research Netwerk
Stichting Vecozo
Stichting tot steun VCVGZ
Strangeways Research
The Icelandic Heart Association
The Stanley Medical Research Institute
TNO-voeding
UMC Utrecht
University of Durham
Personnel and finances 135
University of Oxford
VU Medical Centre
Wyeth Pharmaceuticals Inc.
World Cancer Research Fund
World Health Organization
Zorggroep Almere
136 Annual Report 2008
Research projects 137 Research 137
Research projects (2008)
‘We all know how important it is to learn from our
own mistakes, but for improving patient safety the
challenge is to enable others to learn from our
mistakes as well’
Dorien Zwart, Assistant Professor General Practice
Vocational Training
138 Annual Report 2008
Research projects 139
Cardiovascular Diseases
PhD projects, finished 2008
Name Title JC Discipl
Appelman, A.P.A. (see also
Mental Health)
Brain atrophy in patients with arterial disease. The SMART-MR study
Joint CE
Bax, L. Renal function and atherosclerotic renovascular disease
Joint CE
Brouwer, B.G. SMART risk factor screening in patients at high vascular risk
Intern CE
Dogan, S. Carotid intima-media-thickness: studies into methodological aspects
Intern CE
Eck, J.W.M. van (see also Theor Epi)
Outcomes after pacemaker implantation. Results of the FOLLOWPACE study.
Intern CE
El Fakiri, F. Prevention of cardiovascular diseases in deprived neighbourhoods
Extern GP
Gorter, P.M. Insulin resistance and adipose tissue in the development of vascular diseases in high-risk patients
Joint CE
Hajer, G.R. Vascular risk factors and adipocyte dysfunction in metabolic syndrome
Joint CE
Halkes, P.H.A. ESPRIT (European/Australasian Stroke Prevention in Reversible Ischaemia Trial) and related studies
Extern CE
Janssen, P.G.H. Screening for type 2 diabetes in general practice
Intern CE, GP
Knol, M.J. (see
also Mental Health)
Depression and diabetes. Methodological issues in etiologic research
Joint CE
Koffijberg, H. New decision analytical models for management of intracranial aneurysms
Intern MTA
140 Annual Report 2008
Lebrun, C.E.I. Determinants of physical aging among healthy postmenopausal women and their relation with serum hormone levels
Extern CE
Molenaar, E.A. Obesity matters: Findings in the Utrecht Health Project and the Framingham Heart study
Intern CE, GP
Pruissen, M. Prothrombotic genevariation and cerebral ischaemia ofarterial origin
Extern CE
Rutten, A. Multi-detector row CT of the heart: methodological evaluation and application in high-risk patients
Extern CE
Tjang, Y.S. Predicting outcome of heart transplantation
Joint CE
Toll, D.B. (see
also Theor. Epi.)
Excluding Deep Vein Thrombosis in primary care: validation, updating, and implementation of a diagnostic rule
Intern CE, GP
Zafarmand, M.H.
Genetic risks for cardiovascular diseases Intern CE
PhD projects, ongoing
Name Title JC Discipl
Abeelen, A.F.M. van
Dutch famine and cardiovascular disease
Joint CE
Arts, I. Determinants of disability in older persons
Joint CE
Avendonk, M.J.P. van
Insulin therapy in diabetes type 2 patients in general practice
Intern GP
Baan, F.H. van der
Optimising the benefits and safety of new drugs: prospects pharmacogenetics/-genomics, safety monitoring
Intern CE
Bauer, F. IOP Genomics project: The role of inflammation in obesity-induced type 2 diabetes
Intern CE
Research projects 141
Beelen, R.M.J. Long-term effects of traffic-related air pollution on respiratory and cardiovascular mortality.
Extern CE
Berg, M.J. van den
Expert patients as a coach in a self-management program for newly diagnosed patients with diabetes type 2
Joint GP, NS
Beus, M.F. de SPORTCOR Sudden cardiac arrest and electrocardiographic patterns in athletes
Joint CE
Bijker, J. (see
also Theor. Epi.)
Intra-operative hypotension and adverse outcome after surgery
Joint CE
Bilecen, S. (see
also Theor. Epi)
Transufion strategies in cardiac surgery Joint CE
Boelhouwer-Jacobsen, D.E.
Efficacy of tibolone and raloxine on the maintenance of muscle strength, bone mineral density and cognitive function in late postmenopausal women.
Extern CE
Boonman-de Winter, L.J.M.
Heart failure in diabetes Extern GP
Bozkurt, O. (see
also Mental Health)
UDES project pharmacy Joint CE
Bruggen, J.A.R. van
Quality of diabetes care in general practice
Intern GP
Bruggink-André de la porte, P.W.F.
Effects of heart failure management programmes
Extern CE, GP
Bruins Slot, M.H.E. (see also
Theor. Epi.)
Improving the early diagnosis of myocardial infarction in primary care: the added value of a rapid assay to detect heart-type FABP, a novel marker of myocardial injury – PhD project 2.
Intern CE, GP, MTA
Cleveringa, F.G.W.
Diabetes care Inplementation Study (DIS)
Intern CE, GP
142 Annual Report 2008
Dekker, M.S. FAME-ER, Improving the assessment of patients presenting to the emergency room with suspected myocardial infarctation: the diagnostic value of h-FABP, an early biomarker of cardiac injury
Joint CE, GP
Dieleman, S. (see also Theor. Epi)
Cognitive decline and long term outcome after cardiac surgery
Joint CE
Dieren, S. van Optimizing the prediction of absolute CVD risk among type 2 diabetes patients
Intern CE, GP
Elbers, C.C. Role of inflammation in obesity-induced type 2 diabetes, Phd study
Intern CE
Emmelot-Vonk, M.H.
Effects of testosterone suppl. On functional mobility, quality of life, body composition, cognitive function, vasc. Ageing, and bone mineral density in testosterone deficient men, PhDproject1
Intern CE
Engelsen, C. den
IJSCO-2: IJsselstein Study of Central Obesity-2
Intern CE, GP
Ettema, R.G.A. (see also Theor. Epi.)
Improving outcomes of cardiac surgery in elderly patients
Joint CE
Gast, G.C.M. Women with climacteric complaints, a group with a net benefit of postmenopausal hormone therapy?
Joint CE
Geersing, G.J. (see also Theor. Epi.)
Diagnosis of pulmonary embolism in primary care: The AMUSE 2 study
Intern CE, GP
Geerts, C.C. The relation between early childhood obesity and arterial disease
Intern CE
Gerritsen, L. (see
also Mental Health)
Psychological stress and depression as risk factors for cognitive decline and Alzheimer’s disease
Intern CE
Gondrie, M.J.A. (see also Theor. Epi.)
PROVIDI: Prognostic value of unrequested information in diagnostic imaging
Intern CE
Research projects 143
Grool, A.M. (see
also Mental Health)
Cerebral small-vessel disease and depression in patients with manifest arterial disease: cause or consequence?
Intern CE
Hendrix, A. The yield of cardio-genetic screening of 1st degree relatives of sudden cardiac and unexplained death victims <45 y (CAREFUL)
Joint CE
Idris, B.I. (see also
Theor. Epi.)
Long-term outcomes in cardiac surgery Intern CE
Jacobs, P.C.A. Beyond clinical diagnosis: the prognostic value of unrequested information in diagnostic imaging (PROVIDI)
Joint CE
Jong, S.E.C.A. de
(DREAM)on: Dutch Randomised Endovascular Aneurysm Management Trial – 2nd part.
Extern CE
Jongen, L.M. Cerebral perfusion and cerebral vascular morphology in patients with symptomatic carotid artery stenosis
Extern CE
Kelder, J.C. Diagnostic strategies in patients suspected of heart failure
Intern CE, GP
Knoops, A.J.G. (see also Mental
Health)
The etiology of Alzheimer disease: an innovative hypothesis of depression, vulnerability an biological interaction
Intern CE
Kurniati, N. HIV infection in children - AsiaLink CE-EBM
Intern CE
Laar, F. van de Nutritional and pharmaceutical treatment aspects in newly diagnosed type 2 diabetes patients in general practice
Extern GP
Lugt, R. van der Addition 2 Intern CE
Maessen, M. Determinants of end-of-life decisions in ALS: prospective study
Extern CE
Mazairac, A.H.A.
Cost effectiveness of increased convective clearance by online hemodiafiltration on all cause mortality in chronic hemodialysis patients: the CONTRAST study
Joint CE
144 Annual Report 2008
Meijs, M.F.L. Non invasive cardiac imaging Joint CE
Nijdam, M.E. Elevated blood pressure in young adults Intern CE
Oudejans-Mooijaart, I.
Diagnosis of heart failure in the elderly Extern CE
Penne, E.L. Aspects of online hemodiafiltration in chronic hemodialysis patients: the CONTRAST study
Joint CE
Regieli, J.J. Prognosis in ischemic heart disease. Impact and molecular determinants of collateral circulation – the SMART study and REGRESS trial cohorts
Joint CE
Scheltens, T. Prevention of cardiovascular diseases in primary care
Intern CE, GP
Siccama, R.N. (see also Theor. Epi.)
Diagnosis of venous thromboembolism in the elderly: The VT elderly study
Intern CE, GP
Sluijs, I.S. The effect of environmental as well as genetic factors on selected biomarkers of pathophysiological pathways thusfar known to be involved in the ethiology of type 2 diabetes
Intern CE
Spoel, O.P. van der (see also Theor.
Epi.)
Improving the early diagnosis of myocardial infarction in primary care: the added value of a rapid assay to detect heart-type FABP, a novel marker of myocardial injury – PhD project 1.
Intern CE, GP, MTA
Sol-de Rijk, B.G.M.
Self-management of vascular riskfactors Extern CE
Svircevic, V. (see
also Theor. Epi.)
Optimal anesthesial techniques in cardiac surgery
Extern CE
Uijl, I.E.M. den Long term outcome of mild and moderate haemophilea
Intern CE
Vaartjes, C.H. Cerebrovascular disease and peripheral arterial disease in the Netherlands: incidence and prognosis
Intern CE
Verheugt, C.L. Prognosis of adults with congenital heart disease in the CONCOR national registry
Intern CE
Research projects 145
Vlak, M. Triggers for rupture of intracranial aneurysms
Extern CE
Vlek, A.L.M. Parameters of cardiovascular disease-the SMART study (definitive title to be decided)
Intern CE
Voorneman, I. Beyond expectations Extern GP, Psych
Vos, A.M. de Cardiac imaging in patients with peripheral arterial disease
Joint CE
Weerd, M. de Chronic renal insufficiency in the Netherlands, incidence and prevalence. + Is screening of asymptomatic carotid stenosis to prevent stroke risk cost effective
Intern CE
Weerd, N. de Early indicators on benefit of online hemodiafiltration in chronic hemodialysis patients: the CONTRAST study
Extern CE
Wermer, M. Aneurysm Screening after surgical Treatment in Ruptured Aneurysms (ASTRA)
Extern CE, MTA
Westerhuis, M.E.M.H. (see
also Theor. Epi.)
The cost-effectiveness of ST-analysis of the fetal electrocardiogram as compared to fetal blood sampling for intrapartum monitoring: an individual controlled trial
Joint CE
Zaane, B. van (see also Theor. Epi.)
Diagnostic value of an innovative non-invasive diagnostic to determine the grade of atherosclerosis before sternotomy in patients scheduled for cardiac surgery
Joint CE
146 Annual Report 2008
Other projects, finished 2008
Name Title JC Discipl
Bobbink, W.G. The IJsselstein screening for central obesity to detect metabolic syndrome
Intern CE, GP
Bots, M.L. Possible effects of supplementation with cis-9, trans-11 conjugated linoleic acid on markers of atherosclerosis
Intern CE
Bots, M.L. Cardiac imaging and risk of CVD PAD patients: GROUND study
Intern CE
Other projects, ongoing
Name Title JC Discipl
Berg, M.J. van den
Expectations and preferences of people with type 2 diabetes mellitus with regard to changes in primary diabetes care
Intern CE, GP
Beulens, J.W.J. Nutrition, type 2 diabetes and cardiovasular disease
Intern CE, NS
Bots, M.L. Effects of increased convective clearance by online hemodiafiltration on all cause mortality in chronic hemodialysis patients. (CONTRAST)
Intern CE
Bots, M.L. Optimal risk factor management in CRI patients and risk of CVD events: MASTERPLAN
Intern CE
Bots, M.L. Carotid intima-media thickness measurement (CIMT): is it useful for clinical practice?
Intern CE
Bots, M.L. Polypill trial (Pill Pilot) Intern CE
Donk, M. van den
Quality of life in screen detected type 2 DM patients
Intern CE, GP
Graaf, Y. van der Soedamah-Muthu, S.S.
SMART: Second Manifestations of ARTerial disease
Intern CE
Research projects 147
Greving, J.P. Balancing the risks and benefits in primary prevention. Development of an individualised approach.
Intern CE
Grobbee, D.E. Soedamah-Muthu, S.S.
ADVANCE: Action in Diabetes and Vascular Disease, an international multicenter clinical trial on the effects of Perindopril-Indapamide and Glicazide on cardiovascular disease in patients with diabetes mellitus type 2
Intern CE
Kluijtmans, M. IPD analysis of on- versus off pump coronary bypass surgery
Intern CE
Koffijberg, H. Cardiovascular prevention at old ages, competing risks, competing costs, frailty and indirect medical costs
Intern MTA
Linden, M.W. van der
Cognition in screen/detected patients with type 2 diabetes mellitus in primary care± two and five years follow/up after randomisation towards intensive or standard treatment
Intern CE, GP
Onland-Moret, N.C.
Role of inflammation in obesity-induced type 2 diabetes
Joint CE
Peelen, L.M. (see
also Theor. Epi.)
Theoretical epidemiology in cardiovascular surgery
Intern CE
Peeters, P.H.M. (see also Cancer)
PROSPECT: European prospective investigation into cancer and nutrition
Intern CE
Peeters, P.H.M. (see also Cancer)
EPIC-nl; European Prospective Investigation into Cancer and nutrition-Netherlands
Joint CE
Peeters, P.H.M. (see also Cancer and
Theo. Epi.)
Innovation of dietary assessment methods in epidemiological studies and public health (IDAMES)
Extern CE
Rutten, G.E.H.M.
NAVIGATOR: Efficacy and safety of long term administration of nateglinide and valsartan in the prevention of diabetes and cardiovascular outcome
Intern GP
Schouw, Y.T. van der
European Prospective Investigation into Cardiovascular diseases (EPIC-Heart)
Intern CE
148 Annual Report 2008
Schouw, Y.T. van der
Nederland de Maat genomen Joint CE
Sonsma, A.C.M. Application of nurse practitioners at the vascular center
Intern CE
Verheus, M. Does equol-producer capacity determine beneficial effect of soy?
Intern CE
Wamsteker, E.W.
HOOP-study: Baseline expectations and the effect of weight reduction therapy. Does changing baseline expectations prevent undesired weight gain within the first two years after treatment?
Intern NS
Welsing, P.M.J. EBM education en rheumatology research
Joint CE
Research projects 149
Infectious Diseases
PhD projects, finished 2008
Name Title JC Discipl
Bont, J. Lower respiratory tract infections in the elderly: Prognostic studies in primary care
Intern GP
Dool, C. van den
Prevention of influenza in health care settings: models and observations
Intern CE, GP
Jong, B.M. de Lower respiratory tract illness in young children: Predictors of disease and health care utilization
Joint CE, GP
Kempen, E.E.M.M. van
Transportation noise exposure and children’s health and cognition
Extern CE
Scholtens, S. Breastfeeding, overweight and asthma in Dutch children. The PIAMA birth cohort study.
Extern CE
Suarthana, E. Predicting occupational lung diseases Joint CE
Visscher, S. Bayesian network models for the management of ventilator-associated pneumonia
Extern CE
Zuidgeest, M.G.P.
Children and asthma medication. When is that inhaler just a breath away?
Extern CE
PhD projects, ongoing
Name Title JC Discipl
Aardweg, M.T.A. van den
Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections
Extern CE, GP
Ammerlaan, H.S.M.
MRSA, clinical epidemiologie Extern CE
150 Annual Report 2008
Bolkenbaas, M. 13-valent pneumococcal conjugate vaccin efficacy in prevention in prevention of pneumococcal CAP and IPD, efficacy in primary care
Intern CE
Boonacker, C.W.B. (see also
Theor. Epi.)
Optimizing the transferability and applicability of trial results to other countries
Intern CE
Broekhuizen, B.D.L. (see also
Theor. Epi.)
FRESCO study: Diagnostic Strategies for COPD in coughing patients in general practice
Intern CE, GP
Derde, L.P.G. Mastering hOSpital Antibiotic Resistance in Europe (MOSAR); ICU trial (WP3)
Intern CE
Ermers, M.J.J. Local anti-inflammatory treatment in the prevention of long-term airway morbidity following hospitalisation for respiratory syncytial virus infection: clinical efficacy and immunological correlates.
Extern CE
Gils, E.J.M. van Effect of 2 versus 3 pneumococcal conjugate vaccinations Prevnar ® on nasopharyngeal carriage, transmission and herd immunity; a randomized, controlled study
Joint CE, GP
Groenwold, R.H.H. (see also
Theor. Epi.)
Control and Quantification of confounding by indication in non-randomised studies: Methodological inquiry using an example of vaccine effectiveness
Intern CE, GP
Gourieva, T. Mathematical modelling of MRSA Intern CE
Harimurti, K.H. AsiaLink CE-EBM projectPneumonia in the elderly
Intern CE
Helsper, C.W. Improving diagnosis in Hepatitis C in General Practice
Intern CE, GP
Houben, M.L. Perinatal determinants, including amniotic fluid inflammation and innative immunity, of infant wheeze and RSV lower respiratory infection.
Extern CE
Research projects 151
Huijts, S.M. CAPITA, aRCT of 13-valent pneumococcal conjugate vaccine efficacy in prevention of vaccine-serotype pneumococcal CAP en IPD
Intern CE
Jongerden, I.P. Endotracheal suctioning in ICU patients: towards an evidence based guideline
Extern CE, NS
Kurniati, N. AsiaLink CE-EBMHIV infection in children
Intern CE
Looijmans-van den Akker, I.
Evaluation of influenza vaccinations in healthy adults
Intern CE, GP
Meijboom, M.J. Cost-effectiveness (CEA/CUA) of influenza vaccination programmes during interpandemic & pandemic years
Extern CE, GP
Melsen, W.G. Nosocomial infections and mortality Intern CE
Oostdijk, E. SDD and SOD: effects on antibiotic resistance in ICUs
Extern CE
Pijpers, E.J. CHAMP - Changing behaviour of Health care professionals And the general public towards a More Prudent use of anti-microbial agents & Arti-4
Intern GP
Ruskamp, J.M. Upper respiratory tract infections in children; the role of atopy, environmental and life style factors, and genetic polymorphisms in a prospective birth cohort study
Extern CE
Soares da Silva, A.
Air polution study in São Paulo, Brazil Extern CE
Steenhof, M. Risk evaluation of ultrafine (nanosize) ambient particulate matter
Extern CE
Venekamp, R.P. PRET-study: Prednisolone Rhinosinusitis Efficacy Trial
Extern CE, GP
Vugt, S.F. van GRACE (WP 09 + 10) Intern CE, GP
Wassenberg, M.W.M.
Rapid diagnostics of MRSA Extern CE
152 Annual Report 2008
Willers, S.M. Environmental and life style determinants of childhood asthma and allergy in birth cohort
Extern CE
Zuurbier, M.M.M.
TRAVEL: Transport Related Air pollution, Variance in commuting, Exposure and Lung function
Extern CE
Other projects, finished 2008
Name Title JC Discipl
Hak, E.Rovers, M.M.
Respiratory tract infections and prescribing antibiotics in Dutch General Practice; from the second Dutch National Survey on General Practice
Joint GP
Other projects, ongoing
Name Title JC Discipl
Bootsma, M. Mathematical tools in support of infection prevention
Extern CE
Dool, C. van den
Mathematical modelling of infection diseases
Intern CE
Rovers, M.M. Which children with acute otitis media benefit from treatment with antibitics? An individual patients data meta-analysis
Intern CE, GP
Trapman, J.P. Mathematical modelling of infection diseases
Intern CE
Velden, A.W. van der
Implementation of a multiple intervention aimed at optimising prescription of antibiotics for respiratory tract infections, embedded within the new practice accreditation of the Dutch College of General Practitioners; a randomised controlled trial
Joint GP
Research projects 153
Verhoeff, M. The effectiveness of treatment with co-trimoxazol in children with chronic otitis media
Extern CE
154 Annual Report 2008
Cancer
PhD projects, finished 2008
Name Title JC Discipl
Haars, G. A new look at breast density and breast cancer risk
Intern CE
May, A.M. (see
also Mental Health)
Rehabilitation in cancer: Training and talking? Effects of physical training versus physical training combined with cognitive-behavioural therapy
Intern NS
Vernooij, F. Ovarian cancer treatment in The Netherlands. The effect of care provider on the outcomes of treatment between 1996 and 2003
Extern CE, MTA
PhD projects, ongoing
Name Title JC Discipl
Bhoo Pathy, N. Lifestyle and Cancer (AsiaLink CE EBM) Intern CE
Braunius, W. Diagnostic management in patients with head and neck malignancies
Joint CE
Hertogh, E.M. SHAPE/PANACEA Intern CE
Horrée, N. Molecular biology in endometrial carcinogenesis
Extern CE
Kars, M.C. PRESENCE study: The experiences, needs, coping strategies and professional support of parents caring at home for a child with cancer during the palliative phase
Intern NS
Klerkx, W. MR imaging: the efficacy of non-invasive techniques to detect lymph node involvement in gynecologic malignancies
Joint CE
Kok, L. (see also
Theor. Epi)
Early diagnosis of organic bowel diseases in primary care
Intern CE, GP
Research projects 155
Lokate, A.J.M. Changes in mammographic density and breast cancer risk (Prospect/EPIC)
Intern CE
Oosterom, M. (see also Mental
Health)
NUCAI: The effect of comprehensive counseling by a specialized nurse on depressive symptoms and quality of life: a randomised study.
Intern NS
Peters, H.G.M. MRI in nonpalpable breast lesions: towards less invasive diagnosis and treatment
Joint CE
Velthuis, M.J. PACT-Study: The influence of physical activity during (breast) cancer chemotherapy on fatigue, fitness and wellbeing
Extern CE
Winden, A.W.J. van
The use of proteomics in the etiologic epidemiology of breast cancer
Intern CE
Other projects, finished 2008
Name Title JC Discipl
Elias, S.G. (see
also Theor. Epi.)
Prediction rules for cancer Joint CE
Monninkhof, E.M.
Physical activity and breast cancer risk: a trial in postmenopausal women
Intern CE
Peeters, P.H.M. EPIC-ELDERLY NAH Joint CE
Other projects, ongoing
Name Title JC Discipl
Duijnhoven, F.J.B. van
SOR project: fruit and vegetables in relation to colonrectal cancer in epic
Extern CE
Gamel, C.J. Care for (relatives of) patients with cancer
Intern NS
Gils, C.H. van, Carotenoids, Vitamin C and risk of Breast Cancer in the European Prospective Investigation into Cancer and Nutrition
Joint CE
156 Annual Report 2008
Huitema, M.C. Effectiveness of oncological follow-up by specialized nurses
Joint NS
May, A.M. Physical activity, nutrition, alcohol, cessation of smoking and eating out of home in relation to obesity
Intern CE
Monninkhof, E.M.
Nutrition, hormones and genes in relation to cancer
Intern CE
Noord, P.A.H. van
DOM project: Diagnostic Investigation Mamma Carcinoma
Intern CE
Noord, P.A.H. van
Trans generational effects of famine Intern CE
Onland-Moret, N.C.
The progesterone synthesis, binding and metabolism pathway and the risk of ovarian cancer
Intern CE
Peeters, P.H.M. (see also
Cardiovascular
diseases)
PROSPECT: European prospective investigation into cancer and nutrition
Intern CE
Peeters, P.H.M. (see also
Cardiovascular
diseases)
EPIC-nl; European Prospective Investigation into Cancer and nutrition-Netherlands
Joint CE
Peeters, P.H.M. (see also
Cardiovascular
diseases and Theor.
Epi.)
Innovation of dietary assessment methods in epidemiological studies and public health (IDAMES)
Extern CE
Peeters, P.H.M. ElectroMagnetischeVelden (EMV) and health
Joint CE
Vrieling, A. SOR-project: fruit and vegetables in relation to pancreatic cancer in EPIC
Extern CE
Research projects 157
Mental Health
PhD projects, finished 2008
Name Title JC Discipl
Aanen, M. Studies on gastroesophageal reflux disease
Extern GP
Appelman, A.P.A. (see also
Cardiovascular
diseases)
Brain atrophy in patients with arterial disease. The SMART-MR study
Joint CE
Bijkerk, C.J. Irritable bowel syndrome in primary care
Intern GP
Knol, M.J. (see
also Cardiovascular
diseases)
Depression and diabetes. Methodological issues in etiologic research
Joint CE
Laan, W. Anti-inflammatory drugs and psychosis Intern CE
May, A.M. (see
also Cancer)
Rehabilitation in cancer: Training and talking? Effects of physical training versus physical training combined with cognitive-behavioural therapy
Intern NS
Velden, A.W. van der
Long-term treatment of gastro-oesophageal reflux disease in primary care
Intern GP, MTA
PhD projects, ongoing
Name Title JC Discipl
Boonstra, G. Quiting-study antipsychotic medicine Extern CE
Bosman, M. Prevention of self-harm in psychiatric inpatients
Extern NS
Bozkurt, O. (see
also Cardiovascular
diseases)
UDES project pharmacy Joint CE
Breetveld, E.J. Building blocks of emotion and behaviour in the general population
Extern CE, GP
158 Annual Report 2008
Clignet, F.G.H.M.
Physical excercise in depressed elderly: The development of a nursing intervention
Extern NS
Dieleman, J.M. (see also Theor. Epi.)
Prophylactic corticosteroids in cardiac surgery
Extern CE
Fluttert, F.A.J. Prevention of violence in forensic psychiatry
Extern NS
Gerritsen, L. (see
also Cardiovascular
diseases)
Psychological stress and depression as risk factors for cognitive decline and Alzheimer’s disease
Intern CE
Grool, A.M. (see
also Cardiovascular
diseases)
Cerebral small-vessel disease and depression in patients with manifest arterial disease: cause or consequence?
Intern CE
Heeg, B.M.S. (see also Theor. Epi.)
Health economic modeling of complex systems; the case of schizophrenia
Extern MTA
Houtjes, W. Development of protocol for the assesment of needs and the application of individualized nursing interventions in depressed elderly
Extern NS
Joosten, G. ‘Deciding Together’: A research into the effectiveness of making a standardised treatment agreement in the addiction treatment care
Extern PH
Knook, L.M.E. Prognosis of children referred for unexplained chronic pain: the PUC (Pediatric Unexplained Chronic pain) study
Extern CE
Knoops, A.J.G. (see also
Cardiovascular
diseases)
The etiology of Alzheimer disease: an innovative hypothesis of depression, vulnerability an biological interaction
Intern CE
Koekkoek, B. The development and testing of a best-practice program for nursing care for chronically depressed patients
Joint NS
Kok, L. CEDAR study: optimal discrimination between organic and functional causes of chronic abdominal pain.
Intern GP
Research projects 159
Lee-Kwon, S. Primary Caregivers perception of a long term care facility for their demented elders in Korea and intervening factors of those perceptions
Extern NS
Leeuw, M.G.C. de
Quality of the working alliance in Assertive Community Treatment
Extern NS
Meijer, B Determinants of cognitive decay in the HALE project
Extern CE
Oberndorff Klein Wolthuis, A.
Effectiveness of mebeverine in IBS in primary care
Extern CE, GP
Oosterom, M. (see also Cancer)
NUCAI: The effect of comprehensive counseling by a specialized nurse on depressive symptoms and quality of life: a prospective randomised study.
Intern NS
Pruijssers, A.C. Multidisciplinary diagnostics of anxiety related behavioural disorders in patients with intellectual disabilities
Joint NS
Reincke, C. A clinical prospective cross-sectional diagnostic study on the referral for screening for epilepsy surgery
Extern CE
Smeets, H.M. ARAMIS: analysis of the effectiveness of a PPI reduction programme
Extern GP
Stegenga, B.T. Depression and anxiety in primary care Intern CE, GP
Verkaik, R. Nursing care for depressed elderly with dementia in nursing homes: A multi centre intervention study into the effects of a nursing guideline
Extern NS
Visscher, A.J.M. Prevention of violent behaviour in patients with Acquired Brain Injury.
Extern NS
Zegwaard, M.I. Family care of elder persons with chronic psychiatric problems and difficult behaviour
Extern NS
Zuithoff, N.P.A. (see also Theor. Epi.)
Prediction of depression in primary care Intern CE, GP
160 Annual Report 2008
Other projects, ongoing
Name Title JC Discipl
Boter, H. The european first episode schizophrenia trial
Extern CE
Hage, S. Self-management strategies for adolescents with violent behaviour
Extern NS
Matthijs, W. Treatment of children with functional disorders or behaviour disorders
Extern MTA
Nuboer, V.S.P. Prevention of suicide in patients with schizophrenia
Extern NS
Peijnenburg, R. The development of a nursing guideline aimed at the reduction of agitated behaviors in patients with dementia
Extern NS
Stel, H.F. van, Swaans, I.J.E.M., Weert-van Oene, G.H. de
Early diagnosis of psychosocial problems in children of 0-4 years in child health centers
Intern PH
Villevoye, D.P.J. Out of school prevention of alcohol and drugs in the European countries
Extern PH
Weert-van Oene, G.H. de
Demand driven mental health care in Utrecht: baseline measurement with respect to care programming in mental health facilities in the region Utrecht
Intern PH
Research projects 161
Theoretical Epidemiology and Biostatistics
PhD projects, finished 2008
Name Title JC Discipl
Eck, J.W.M. van (see also
Cardiovascular
diseases)
Outcomes after pacemaker implantation. Results of the FOLLOWPACE study.
Intern CE
Koopman, L. Pooling of individual patient data from clinical trials. Improvement of analyses of subgroups
Intern CE
Toll, D.B. (see also
Cardiovascular
diseases)
Excluding Deep Vein Thrombosis in primary care: validation, updating, and implementation of a diagnostic rule
Intern CE, GP
Uijl, S.G. Decision-making in temporal lobe epilepsy surgery
Joint CE
PhD projects, ongoing
Name Title JC Discipl
Baart, A.M. Prediction of future hemoglobin levels in whole blood and plasma donors
Joint CE, MTA
Bax, L.J. Synthesis of clinical research data: innovations in methods and applications
Intern CE, BS
Bij, S. van der Asbestos and Health: Compensation, Damages and Methodology
Intern CE, MTA
Bijker, J. (see also
Cardiovascular
diseases.)
Intra-operative hypotension and adverse outcome after surgery
Joint CE
Bilecen, S. (see
also Cardiovascular
diseases)
Transufion strategies in cardiac surgery Joint CE
Boonacker, C.W.B. (see also
Infectious Diseases)
Optimizing the transferability and applicability of trial results to other countries
Intern CE
162 Annual Report 2008
Borkent-Raven, B.A.
The relationship between the cost-effectiveness of blood safety measures and the distribution of patients who receive blood
Intern MTA
Bouwmeester, W.
Prediction models in multilevel data Intern CE
Broekhuizen, B.D.L. (see also
Infectious Diseases)
FRESCO study: Diagnostic Strategies for COPD in coughing patients in general practice
Intern CE, GP
Bruins Slot, M.H.E. (see also
Cardiovascular
diseases)
Improving the early diagnosis of myocardial infarction in primary care: the added value of a rapid assay to detect heart-type FABP, a novel marker of myocardial injury - PhD project 2.
Intern CE, GP, MTA
Dieleman, J.M. (see also Mental
Health)
Prophylactic corticosteroids in cardiac surgery
Extern CE
Ettema R.G.A. Prediction and prevention of postoperative complications in elderly undergoing cardiac surgery
Joint CE
Ettema, R.G.A. (see also
Cardiovascular
diseases.)
Improving outcomes of cardiac surgery in elderly patients
Joint CE
Geersing, G.J. (see also
Cardiovascular
diseases.)
Diagnosis of pulmonary embolism in primary care: The AMUSE 2 study
Intern CE, GP
Gondrie, M.J.A. (see also
Cardiovascular
diseases)
PROVIDI: Prognostic value of unrequested information in diagnostic imaging
Intern CE
Graaf-Verhave, R. van der
Justice in research ethics Intern Med. Ethics
Research projects 163
Groenwold, R.H.H. (see also
Infectious Diseases)
Control and Quantification of confounding by indication in non-randomised studies: Methodological inquiry using an example of vaccine effectiveness
Intern CE, GP
Groot, J.A.H. de Diagnostic research in the absence of a ‘gold’ standard.
Joint CE, BS
Heeg, B.M.S. (see also Mental
Health)
Health economic modeling of complex systems; the case of schizophrenia
Extern MTA
Idris, B.I. (see also
Cardiovascular
diseases.)
Long-term outcomes in cardiac surgery Intern CE
Janssen, M.P. Transfusion Technology Assessment collaboration with Sanquin Blood Supply Foundation
Intern MTA
Kappen, T.H. IMplementation of a Prediction rule in Anesthesia practice to improve Cost-effectiveness of Treatment of postoperative nausea and vomiting: the IMPACT trail
Joint CE
Kok, L. (see also
Cancer)
Early diagnosis of organic bowel diseases in primary care
Intern CE, GP
Pauw, M. Comparison of hospitals using the HSMR
Joint CE
Siccama, R.N. (see also
Cardiovascular
diseases.)
Diagnosis of venous thromoboembolism in the elderly: The VT elderly study
Intern CE, GP
Spoel, O.P. van der (see also
Cardiovascular
diseases)
Improving the early diagnosis of myocardial infarction in primary care: the added value of a rapid assay to detect heart-type FABP, a novel marker of myocardial injury - PhD project 1.
Intern CE, GP, MTA
Svircevic, V. (see
also Cardiovascular
diseases)
Optimal anesthesi techniques in cardiac surgery
Extern CE
164 Annual Report 2008
Westerhuis, M.E.M.H. (see
also Cardiovascular
diseases)
The cost-effectiveness of ST-analysis of the fetal electrocardiogram as compared to fetal blood sampling for intrapartum monitoring: a randomised controlled trial
Extern CE
Zaane, B. van (see also
Cardiovascular
diseases.)
Diagnostic value of an innovative non-invasive diagnostic to determine the grade of atherosclerosis before sternotmy in patients scheduled for cardiac surgery
Joint CE
Zuithoff, N.P.A. (see also Mental
Health)
Prediction of depression in primary care Intern CE, GP
Other projects, finished 2008
Name Title JC Discipl
Elias, S.G. (see
also Cancer)
Prediction rules for cancer Joint CE
Other projects, ongoing
Name Title JC Discipl
Bootsma, M.C.J. Mathematical tools in support of infection prevention
Intern CE
Janssen, K.J.M. Methods for multivariable diagnostic and prognsotic prediction research
Intern CE, MTA
Knol, M.J. Escher project Intern MTA
Koffijberg, H. Cardiovascular prevention at old ages, competing risks, competing costs, frailty and indirect medical costs
Intern CE
Peelen, L.M. (see
also Cardiovascular
diseases)
Theoretical epidemiology in cardiovascular surgery
Intern CE
Peeters, P.H.M. Innovation of dietary assessment methods in epidemiological studies and public health (IDAMES)
Extern CE
Research projects 165
Rovers, M.M. Methodological challenges of subgroup analyses in IPD meta-analyses
Intern CE, MTA
Vergouwe, Y. Diagnostic prediction rules: innovative methods to improve their applicability
Intern CE, MTA
166 Annual Report 2008
Miscellaneous
PhD projects, finished 2008
Name Title JC Discipl
Dietz, V. Preservation of the uterus in vaginal prolapse surgery: the sacrospinous hysteropexy
Extern CE
Hofhuis, J.G.M. Health related quality of life in critically ill patients
Extern PH
PhD projects, ongoing
Name Title JC Discipl
Berk, M.B. Evaluation patient organisations Intern PH
Bernabe, R.B. Ethical and societal dilemmas and prospects in the timely and safe availability of new drugs to individuals
Intern Med. Ethics
Boogaard, J.M.C.
Integrated assessment of health risks of environmental stressors in Europe (INTARESE)
Extern CE
Bruijn, C. de Cognitive behavioural treatment for sub-acute shoulder disorders
Extern CE
Bruns-Neumann, E.E.
Support of parents of premature children
Extern NS
Buiting, H. Evaluation of the law on euthanasia Extern MTA
Dijkstra-Chaves, L.M.
Prevention of pressure ulcers in home care
Extern NS
Eijk, M.M.J. van Rivastigmine for delirium in intensive care patients: a double blind randomised placebo controlled add on trial
Extern CE
Eland-Kok, P. A patient portal for patients with constitutional eczema: feasibility and effectiveness
Extern NS
Engel, M. Palliative care and presence Intern NS
Research projects 167
Grul, Y.M. Attention, care and professionalism in care for the elderly
Extern NS
Hoogerduijn, J. Prevention of complications in elderly after hospital admission
Joint NS
Jansen, A.J.M. Differences in health perception between physician and patient in chronically ill children
Extern CE
Jong, S.W. de Population based study on Amyotrophic Lateral Sclerosis Netherlands PAN
Extern CE
Jukema, J.S. Presence in caring relationships Joint NS
Klijn, A. Efficacy of home-uroflowmetry in children with dysfunctional voiding (UFO)
Extern CE
Lemmens, L.C. Strategies to improve preoperative care Joint CE
Luiking-Martin, M-L.
Implementation of evidence based practice
Extern NS
Man-van Ginkel, J.M. de
Post stroke depression Extern CE
Moes, H. Development and testing of innovation/implementation measurement instruments
Intern NS
Piepers, S. Effectiveness of non-invasive artificial respiration at home in patients with ALS
Extern CE
Polet, J.C. Development and validation of a multidisciplinary protocol for with-drawal of artificial breathing on IC units
Joint NS
Rademakers, K. Additional value of MRI in prediction of psychomotorical development in premature children: a cost benefit analysis
Extern CE
Simkens, A.B.M. Evaluation of Physician Assistant trainees in Dutch general practices.
Intern PH
Slieker, M.G. Clinical and genetic predictors of cystic fibrosis phenotype
Intern CE
168 Annual Report 2008
Staal, I.I.E. Early detection of problems in bringing-up and development of young children: randomized comparison of house calls versus visits to the child health centre at the age of 18 months
Joint PH
Stefansdottir, G.S.
The future postmarketing phase: requirements & opportunities for better safety research
CE
Stuifbergen, M. Changing familiy ties and caretaking of the elderly
Intern MTA
Sutedja, N.A. Environmental and genetic risk factors for amyotrophic lateral sclerosis (ALS)
Extern CE
Thiel, G.J.M.W. van
Evidence-based ethics: reflective equilibrium as a method for combining empirical and ethical elements.
Intern Med. Ethics
Trappenburg, J.C.A.
Disease management in patients with COPD; New strategies to improve self-management skills and early detection of exacerbations
Intern GP, PH
Vallenga, D. Risk management in care of mentally retarded patients with epilepsy
Extern NS
Other projects, ongoing
Name Title JC Discipl
Belkadi, H. Beheer kwaliteitsMonitor voor Centrum Maliebaan
Extern PH
Bos, N. Meetweek Utrecht 2008. Onderzoek naar spoedzorggebruik in de regio Utrecht
Intern PH
Buskens, E. PATMAN: Patient workflow management systems
Intern MTA
Horsman, M.A. project Horsman Extern GP
Linden, B.A. van der
Meaning of American integrated care programs to Dutch chronically ill patients
Extern PH
Research projects 169
Rooij, S. Early recognition in elderly hospital patients who are at risk for functional impairments
Extern NS
Urbanus-van Laar, J.J.N.
Evaluation Sylvia Toth Center Intern PH
Veenendaal, L.J. van
Onderzoek naar spoedzorg-gebruik in diverse regio’s in Nederland
Intern PH
Weert-van Oene, G.H. de
IMC benchmarking. Routine Outcome Monitoring of patients in impatient motivation centers in substance dependence care
Extern PH
Weldam, S.D.W. Guideline development to stimulate fluid intake
Extern NS
Wulp, I. van der Comparative study of triage systems in the Netherlands
Intern PH
Zweers-de Groot, J.A.M.
Implementation of care homes Extern NS
170 Annual Report 2008
Clinical Trial Services Unit / Research Services
Projects 2008 finished
Project Title Activity
ADVANCE Action in Diabetes and Vascular disease; pretax and Diamicron MR Controlled Evaluation
M CT
CLA Possible effects of supplementation with cis-9, 11 conjugated linoleic acid on markers of atherosclerosis
Site/DM CT
DREAM Dutch Randomised Endovascular Aneurysm Management Trial
M/DM CT
FOLLOW-PACE Complications in first year after pacemaker implants
DM Other
Interact Validering van de EPIC-vragenlijst over lichamelijke activiteit (InterAct-studie).
Site Other
Interaction A phase 3, randomized, double-blind trial evaluate the safety, tolerability, and immunogenicity of a 13-valent pneumococcal conjugate vaccine when administered concomitantly with trivalent inactivated influenza vaccine in healty adults 65 years of age or older who are naïve to 23-valent pneumococcal polysaccharide vaccine
Site CTA
JUPITER Justification for the use of statins in primary prevention: an intervention trial evaluating Rosuvastatin
Site CT
MetCon Effect of a disease-specific sip feed on the postprandial glucoseresponse in type 2 diabetic patients
Site CT
Zoster A study to determine the acceptability of the Zostavax vaccine when simultaneously offered with the influenza vaccination in patients of 65 year and above in the general practice
Site/DM Other
Research projects 171
067 lipids A multicenter, randomized, double-blind, parallel group, 12-week study to evaluate the efficacy and safety of extended-release (ER) niacin/laropiprant. added to statin versus doubling the dose of statin in patients with primary hypercholesterolemia of mixed dyslipidemia.
Site CT
Projects, ongoing
Project Title Activity
AGEING A pilot study to characterize the effects of ageing on the innate immune response against influenza
Site Other
Altitude A randomized, double-blind, placebo-controlled, parallel-group study to determine whether, in patients with type 2 diabetes at high risk for cardio-vascular and renal events, aliskiren, on top of conventional treatment, reduces cardiovascular and renal morbidity and mortality.
M CT
Ascertain Assesment of everolimus in addition to calcineurin inhibitors reduction in maintenance renal transplant recipients
Site (CIMT only)
CT
AUDITOR Atherosclerosis underlying development assessed by intima-media thickness in patients on Rimonabant
Site CT
CONTRAST The Dutch Convective Transport Study M/DMSite
(CIMT/PWV only)
CT
Diasulin Falen van metformine en sulfonylu-reumderivaat combinatietherapie: stop-pen of doorgaan met een sulfonylu-reumderivaat in combinatie met insu-line glargine bij diabetes type 2 patiën-ten in de huisartspraktijk.
Site/DM CT
172 Annual Report 2008
EFC6910 A multicenter, double-blind, randomi-zed, 12-month, placebo-controlled study to evaluate the lipid-lowering effect, safety and tolerability of AVE5530 25 mg/day and 50mg/day when added to ongoing stable statin therapy (HMG-CoA reductase inhibitors) in patients with primary hypercholesterolemia
Site CT
FAME Heart-type Fatty Acid binding protein for early Myocardial infarction Exclusion
Site/DM Other
Grace Genomics to combat resistance against antibiotics in community-acquired LRTI in Europe
PM/DM Other
SKI Specifieke Kindhoest Immuniteit K Only re search-
nurse
Other
INFLUENCE65 A randomised observer-blind, active-controlled phase III study to demonstrate the superior efficacy of GSKBiologicals’adjuvanted infleunza candidate vaccine(GSK2186877A) in elderly aged 65 years or above, as comparedto Fluarix®
Site CT
LRGP Utrecht Health Monitoring Study Leidsche Rijn
Site/DM Other
MASTERPLAN Multifactorial Approach and Superior Treatment Efficacy in renal patients with the aid of nurse practitioners
M/DM CT
MINOES Invloed van 2 en 3 Prevenar® vaccinaties in het RVP pneumokokken neusdragerschap, transmissie en ‘herdimmunity’: een gerandomiseerd, gecontroleerd onderzoek.
M/DM CT
NAVIGATOR Efficacy and safety of long term administration of nateglinide and valsartan in the prevention of diabetes and cardiovascular outcome.
Site CT
Research projects 173
PERFORM Prevention of cerabrovascular and cardiovascular events if ischaemic origin with te rutroban in patients with a history of ischaemic stroke or transient ischaemic attack
Site (CIMT only)
CT
CAPITA Community Acquired Pneumonia Immunization trial in adults-Pilot studies
Site/DM Other
SHARP Study on Heart And Renal Protection M CT
The Dutch ADDITION Study
As part of the Anglo-Danish-Dutch study of intensive treatment in people with screen detected diabetes in primary care
Site/DM CT
PILL Pilot A randomised placebo-controlled trial of fixed-dose combination medication in people at raised risk of cardiovascular disease
Site CT
PREMIUM Perindopril Amlodipine Regimen versus AT1-Receptor Blocker/thiazide: a comparison of Blood pressure Lowering: Efficacy and Safety. A randomised, double blind, 9 month study of the efficacy and safety of four uptitrated doses of oral fixed combinations of perindopril/amlodipine, including a comparison with uptitrated doses of oral fixed combination of irbesartan and hydrochlorothiazide in mild to moderate hypertension.
Site CT
CT = Clinical Trial
M = Monitoring & Projectmanagement
PM = Projectmanagement
DM = Datamanagement
174 Annual Report 2008
Data Management
Project/study Description Type
Addition Anglo-Danish-Dutch study on intensive treatment in people with screen detected diabetes in primary care
Other
Amuse II Questionaire on VTE among GPs Other
Arti 4 Study to reduce antibiotic prescriptions in the GP-practice
Other
Benchmarking OK
Reporting tool for operating room efficiency Other
BKO database Database for quality control of research Other
CAP pilot Prestudy Optimizing Diagnosis of Community-Acquired Pneumonia
Other
CHAMP European online case vignette survey among GP’s
Other
CLA Possible effects of suplementation with cis-9,11 conjugated linoleic acid on markers of artherosclerosis
CT
Contrast The Duth convective transport study CT
Dream-On 5 yrs Followup of Dutch Randomized Endovascular Aneurysm Management (DREAM) trial
CT
ECG evaluation Website for evaluation of ECG’s Other
EPIC Panacea Combining data of all EPIC cohorts Cohort
Epic-NL Combining cohorts PROSPECT (JC) and MORGEN (RIVM)
Cohort
EUCCLID Pilot Treatments in diabetics CT
Fame Paneldiagnosis of patients with acute coronary syndrome
Other
FAME2 Evaluation of cardiac damage in GP practice CT
FFQ Online food frequency questionnaire Other
FollowPace2 Follow-up of patients with pacemakers Cohort
Fresco Diagnostical stategies on COPD Other
Research projects 175
GGD 18 mnd Comparison of consultation office visit or home visit among children from 18 months at GGD Zeeland
Other
GRACE WP2 Genomics to combat Resistance against Antibiotics in Community acquired LRTI in Europe
Other
Ground Multicenter trial in patients with peripheral vascular pathology
CT
Hemofilie Zweden
Questionnaires for patients with haemophilia in Sweden
Other
HNU GP Network Utrecht, database filled with data from 6 general practices in the region Utrecht
Cohort
ICdelirium Rivastigmine for ICU delirium CT
IJsco IJsselsteinse Screening on Central Obesity Cohort
Impetus Implementation and evaluation of transmural work arrangements Diabete mellitus
CT
IPD Surveillance 2
Surveillance of IPD in children Other
IRIS Internet based hospital care for cardiovascular patients
CT
Isala Cardiac surgery database from ISALA (Zwolle) Other
Kema Processing of KEMA questionnaires Other
Leuko Study on leukemia in children Other
Litra Lithium treatment in ALS patients CT
LRGP Utrecht health monitoring study Leidsche Rijn Cohort
Masterplan Multifactorial approach and superior treatment efficicy in renal patients
CT
Memory The use of Palivizumab on RSV-infection in premature babies
CT
Metabase Online survey about bypass surgery in europe Other
Metabolomics Data collection for metabolomics research in children
Cohort
Meteor Plaque VIC
Measurement of plaque within Meteor participants
CT
176 Annual Report 2008
Minoes Randomised trial on the influence of 2 or 3 Prevnar vaccinations on transmission, nasal carrying and herdimmunity.
CT
MIS Onderwijs management information database for educations
Other
Mondriaan Platform for collection and integration of care and research data
Cohort
MOSAR WP3 Mastering hOSpital Antimicrobial Resistance (ICU trial)
CT
MOSAR WP4 Mastering hOSpital Antimicrobial Resistance (hospital wards trial)
CT
MOSAR WP5 Mastering hOSpital Antimicrobial Resistance (rehabilitation center trial)
CT
MTX Intolerance
Therapy in patients with Juvenile Idiopathic Arthritis and Methotrexate related side effects
CT
NICU Database for neonates Cohort
NOA Randomised trial on adenotomy in children CT
NUCAI Patients with cancer in head and neck area treated regular compared to use of counseling
CT
Panacea Ezitimibe and simvastin effect on FMD CT
Panter Pancreatitis, Necrosectomie versus minimally invasive step up approach
CT
PedNet European paediatric network for Haemophilia management
Cohort
PINO Randomised trial of a new vaccinations on pneumococcus versus the regular vaccination.
CT
PRET Treatment of rhinosinusitis-like symptoms CT
Prospect Utrecht cohort for lifestyle and cancer and cardiovascular disease
Cohort
Quofun Questionnaires with jaw cancer patients Other
REACTIE Comparison therapy loyalty in different ways of defining risk
Other
Ripag psychiatric cohort in the region Utrecht Cohort
Research projects 177
Rodin Research Of Determinants of INhibitor development among Previously untreated patients with haemophilia
Cohort
SKI studie Specific Pertussis Immunity CT
SMART Second Manifestations of ARTerial diseases Cohort
Spiegel Patient safety in general practice Other
Spin UTI Trial on preventive antibiotics in children with spina bifida
CT
SportCor Questionnaire on sudden death at sports Cohort
Stem2 Research on perception of quality of care in diabetes
Other
TIKI IVIG treatment in children with acute ITP CT
Topfit Cardiovascular Fitness program in schizophrenia patients
CT
Van Pelt Study in children with rheumatism Other
Vruchtwater Birth cohort study (a) healthy newborns and (b) premature births and newborns born by caesarean
Cohort
VT_Elderly Study whether existing disission rules on diagnosis of DVT are reliabale in nursing homes
Other
VTE_enquete Questionaire on VTE among nursing home physicians
Other
Whistler The wheezing illnesses study Leidsche Rijn (WHISTLER)
Cohort
178 Annual Report 2008
Research projects 179 Education 179
Publications 2008
‘Doing research is a good method of education: it
teaches you to design questions, search for answers,
and assess the truth of the answers you get’
Stijntje Bor, Medical Student,
Winner ‘Frits de Waard’ Award 2008
180 Annual Report 2008
Publications 181
PhD Theses
1 Aanen, M.C. (2008, June 11). Studies on gastroesophageal reflux disease. Utrecht University (139
pag.). Prom./coprom.: prof.dr. A.J.P.M. Smout, dr. A.J. Bredenoord & dr. M.E. Numans.2 Appelman, A.P.A. (2008, May 22). Brain atrophy in patients with arterial disease. The SMART-MR
study. Utrecht University (189 pag.). Prom./coprom.: prof.dr. W.P.T.M. Mali, prof. dr. Y. van der Graaf, dr. M.I. Geerlings & dr.ir. K.L. Vincken.
3 Bax, L. (2008, August 29). Renal function and atherosclerotic renovascular disease. Utrecht University
(160 pag.). Prom./coprom.: prof.dr. W.P.T.M. Mali, prof. dr. Y. van der Graaf & dr. J.J. Beutler Mol.
4 Bijkerk, C.J. (2008, February 26). Irritable bowel syndrome in primary care. Utrecht University (146
pag.). Prom./coprom.: prof.dr. A.W. Hoes, prof.dr. J.A. Knottnerus, dr. N.J. de Wit & J.W.M. Muris.
5 Bont, J. (2008, February 15). Lower respiratory tract infections in the elderly: Prognostic studies in
primary care. Utrecht University (129 pag.). Prom./coprom.: prof.dr. Th.J.M. Verheij, prof.dr. A.W. Hoes & dr. E. Hak.
6 Brandenburg, C.A. (2008, September 4). A transaction cost analysis of Dutch hospital care. Erasmus
University Rotterdam (176 pag.). Prom.: prof.dr. E.G.J. Vosselman, prof.dr. J.P.M. Groenewegen &
prof.dr. A.J.P. Schrijvers.
7 Brouwer, B.G. (2008, May 15). SMART risk factor screening in patients at high vascular risk. Utrecht
University (185 pag.). Prom./coprom.: prof.dr. Y. van der Graaf & dr. F.L.J. Visseren.
8 Dietz, V. (2008, September 2). Preservation of the uterus in vaginal prolapse surgery: the sacrospinous
hysteropexy. Utrecht University (179 pag.) ( Utrecht University). Prom./coprom.: prof. dr. A.P.M.
Heintz, prof.dr. Y. van der Graaf, dr. C.H. van der Vaart & S.E. Schraffordt Koops.
9 Dogan, S. (2008, October 23). Carotid intima-media thickness: studies into methodological aspects.
Utrecht University (185 pag.). Prom./coprom.: prof.dr. D.E. Grobbee & dr. M.L. Bots.
10 Dool, C. van den (2008, October 9). Prevention of Influenza in Health Care Settings: Models and
Observations. Utrecht University (143 pag.). Prom./coprom.: prof.dr. M.J.M. Bonten, dr. E. Hak &
dr.ir. J. Wallinga.
11 Eck, J.W.M. van (2008, May 15). Outcomes after pacemaker implantation : Results of the followpace
study. Utrecht University (152 pag.). Prom./coprom.: prof. dr. N.M. van Hemel, prof.dr. K.G.M. Moons & prof.dr. D.E. Grobbee.
12 El Fakiri, F. (2008, March 14). Prevention of cardiovascular diseases in deprived neighbourhoods.
Erasmus University Rotterdam (141 pag.). Prom./coprom.: M. Berg, prof.dr. A.W. Hoes & dr. M.
Bruynzeels.
13 Gorter, P.M. (2008, March 6). Insulin resistance and adipose tissue in the development of vascular
diseases in high-risk patients. Utrecht University (163 pag.). Prom./coprom.: prof.dr. Y. van der Graaf & dr. F.L.J. Visseren.
14 Haars, G. (2008, September 9). A new look at breast density and breast cancer risk. Utrecht University
(121 pag.). Prom./coprom.: prof.dr. D.E. Grobbee, dr. P.H.M. Peeters, dr. P.A.H. van Noord & dr. C.H. van Gils.
15 Hajer, G.R. (2008, February 21). Vascular risk factors and adipocyte dysfunction in metabolic
syndrome. Utrecht University (175 pag.). Prom./coprom.: prof. dr. E. van der Wall, prof.dr. Y. van der Graaf & dr. F.L.J. Visseren.
16 Halkes, P.H.A. (2008, September 30). ESPRIT (European/Australasian Stroke Prevention in Reversible
Ischaemia Trial) and related studies. Utrecht University (144 pag.). Prom./coprom.: prof.dr. A. Algra
& prof.dr. L.J. Kappelle.
17 Hofhuis, J.G.M. (2008, October 8). Health related quality of life in critically ill patients. Erasmus
University Rotterdam (124 pag.). Prom./coprom.: prof.dr. J. Bakker, prof.dr. A.J.P. Schrijvers, dr. P.E.
Spronk & dr. H. van Stel.
182 Annual Report 2008
18 Janssen, P.G.H. (2008, September 16). Screening for type 2 diabetes in general practice. Utrecht
University (152 pag.). Prom./coprom.: prof.dr. G.E.H.M. Rutten, dr. R.P. Stolk & dr. K.J. Gorter.
19 Jong, B.M. de (2008, January 24). Lower respiratory tract illness in young children: Predictors of
disease and health care utilization. Utrecht University. Prom./coprom.: prof.dr. Th.J.M. Verheij, prof.
dr. C.K. van der Ent & dr. C.S.P.M. Uiterwaal.20 Kempen, E.E.M.M. van. Transportation noise exposure and children’s health and cognition. Utrecht
University. Prom./coprom.: prof.dr.ir. B. Brunekreef, prof. dr. S.A. Stansfeld, prof.dr. E. Lebret & dr. I.
van Kamp.
21 Knol, M.J. (2008, May 29). Depression and Diabetes - Methodological Issues in Etiologic Research.
Utrecht University (224 pag.). Prom./coprom.: prof.dr. D.E. Grobbee, prof.dr. A.C.G. Egberts, dr. M.I. Geerlings & dr. E.R. Heerdink.
22 Koffijberg, H. (2008, May 29). New decision analytical models for management of intracranial
aneurysms. Utrecht University (220 pag.). Prom./coprom.: prof.dr. G.J.E. Rinkel, prof.dr. B.A. van Hout & dr. E. Buskens.
23 Koopman, L. (2008, January 31). Pooling of Individual patient Data from Clinical Trials:
Improvement of analyses of subgroups. Utrecht University. Prom./coprom.: prof.dr. D.E. Grobbee,
dr. M.M. Rovers & dr. G.J.M.G. van der Heijden.
24 Laan, W. (2008, July 3). Anti-inflammatory drugs and psychosis. Utrecht University (127 pag.).
Prom./coprom.: prof.dr. D.E. Grobbee, prof. dr. R.S. Kahn & dr. H. Burger.
25 Lebrun, C.E.I. (2008, March 6). Determinants of physical aging among healthy Postmenopausal
women and their relation with serum hormone levels. Erasmus Universiteit Rotterdam (172 pag.).
Prom./coprom.: S.W.J. Lamberts, prof.dr. D.E. Grobbee & prof.dr.ir. Y.T. van der Schouw.
26 May-de Groot, A.M. Rehabilitation in cancer: Training and talking? Effects of physical training versus
physical training combined with cognitive-behavioural therapy. Utrecht University. Prom./coprom.:
prof.dr. D.E. Grobbee, J. Passchier & dr. W.J.G. Ros.
27 Molenaar, E.A. (2008, September 30). Obesity Matters : Findings in the Utrecht Health Project and
the Framingham Heart Study. Utrecht University (159 pag.) ( Utrecht University). Prom./coprom.:
prof.dr. D.E. Grobbee, dr. M.E. Numans & E.J.C. van Ameijden.
28 Pruissen, D.M.O. (2008, April 1). Prothrombotic gene variation and cerebral ischaemia of arterial
origin. Utrecht University (151 pag.). Prom./coprom.: prof.dr. A. Algra & dr. L.J. Kapelle.
29 Rutten, A. (2008, February 20). Multi-detector row CT of the heart: methodological evaluation and
application in high-risk patients. Utrecht University (180 pag.). Prom./coprom.: prof.dr. W.M. Prokop
& dr. M.L. Bots.
30 Scholtens, S. (2008, June 12). Breastfeeding, overweight and asthma in Dutch children. The PIAMA
birth cohort study. Utrecht University (149 pag.). Prom./coprom.: prof.dr.ir. B. Brunekreef, J.C.
Seidell & A.H. Wijga.
31 Suarthana, E. (2008, June 6). Predicting occupational lung diseases. Utrecht University (127 pag.).
Prom./coprom.: prof.dr.ir. D.J.J. Heederik, prof.dr. D.E. Grobbee & dr. E. Meijer.
32 Tjang, Y.S. (2008, July 10). Predicting Outcome of Heart Transplantation. Utrecht University (144
pag.). Prom./coprom.: prof.dr. D.E. Grobbee, prof.dr. R. Körfer & dr. G.J.M.G. van der Heijden.
33 Toll, D.B. (2008, April 11). Excluding deep vein thrombosis in primary care: validation, updating, and
implementation of a diagnostic rule. Utrecht University (139 pag.). Prom./coprom.: prof. dr. K.G.M. Moons, prof. dr. A.W. Hoes & dr. R. Oudega.
34 Uijl, S.G. (2008, January 31). Decision-making in temporal lobe epilepsy surgery. Utrecht University.
Prom./coprom.: prof. dr. A.C. van Huffelen, prof. dr. K.G.M. Moons & dr. F.S.S. Leijten.
35 Velden, A.W. van der (2008, October 27). Long-term treatment of gastro-oesophageal reflux disease
in primary care. Utrecht University (106 pag.). Prom./coprom.: prof.dr. D.E. Grobbee & dr. M.E. Numans.
Publications 183
36 Vernooij, F. (2008, March 4). Ovarian cancer treatment in the Netherlands : the effect of care provider
on the outcomes of treatment between 1996-2003. Utrecht University (154 pag.). Prom./coprom.:
prof. dr. A.P.M. Heintz, prof.dr. Y. van der Graaf & dr. P.O. Witteveen.
37 Visscher, S. (2008, September 30). Bayesian network models for the management of ventilator-
associated pneumonia. Utrecht University (177 pag.). Prom./coprom.: prof.dr. M.J.M. Bonten, dr.
P.J.F. Lucas & dr. C.A.M. Schurink.
38 Zafarmand, M.H. (2008, October 21). Genetic risks for cardiovascular diseases. Utrecht University
(188 pag.) (Utrecht). Prom./coprom.: prof.dr. D.E. Grobbee & dr. M.L. Bots.
39 Zuidgeest, M.G.P. (2008, October 8). Children and astma medication. When is that inhaler just a
breath away? Utrecht University. Prom./coprom.: prof.dr. H.G. M. Leufkens, prof.dr.ir. B. Brunekreef, dr. M. Bracke & dr. H.A. Smit.
International Refereed Publications
1 Aanen, M.C., Weusten, B.L.A.M., Numans, M.E., Wit, N.J. de, Samsom, M. & Smout, A.J.P.M. (2008).
Effect of proton-pump inhibitor treatment on symptoms and quality of life in GERD patients
depends on the symptom-reflux association. Journal of Clinical Gastroenterology, 42(5), 441-447.
2 Aanen, M.C., Numans, M.E., Samsom, M. & Smout, A.J.P.M. (2008). Reproducibility of symptom
association analysis in ambulatory reflux monitoring. American Journal of Gastroenterology, 103(9),
2200-2208.
3 Aanen, M.C., Bredenoord, A.J., Samsom, M. & Smout, A.J.P.M. (2008). Reliability of oesophageal pH
recording for the detection of gastro-oesophageal reflux. Scandinavian Journal of Gastroenterology,
43 (12), 1442-1447.
4 Aardweg, M.T.A. van den, Rovers, M.M., Ru, J.A. de, Albers, F.W.J. & Schilder, A.G.M. (2008). A
Systematic Review of Diagnostic Criteria for Acute Mastoiditis in Children. Otology & Neurotology,
29(6), 751-757.
5 Abeelen, A.F. van, Krom, M. de, Hendriks, J.C.J.M., Grobbee, D.E., Adan, R.A.H. & Schouw, Y.T. van der (2008). Variations in the uncoupling protein-3 gene are associated with specific obesity
phenotypes. European Journal of Endocrinology, 158(5), 669-676.
6 Achterberg, S., Kappelle, L.J. & Algra, A. (2008). Prognostic modelling in ischaemic stroke study,
additional value of genetic characteristics. Rationale and design. European Neurology, 59(5), 243-252.
7 Aguilera, I., Sunyer, J., Fernandez-Patier, R., Hoek, G., Aguirre-Alfaro, A., Meliefste, K., Bomboi-
Mingarro, M.T., Nieuwenhuijsen, M.J., Herce-Garraleta, D. & Brunekreef, B. (2008). Estimation of
outdoor NO(x), NO(2), and BTEX exposure in a cohort of pregnant women using land use regression
modeling. Environmental Science and Technology, 42(3), 815-821.
8 Akkerman, A.E., Kuyvenhoven, M.M., Verheij, Th.J.M. & Dijk, L. van (2008). Antibiotics in Dutch
general practice: nationwide electronic GP database and national reimbursement rates.
Pharmacoepidemiology and Drug Safety, 17(4), 378-383.
9 Akmatov, M, Kretzschmar, M.E.E., Kramer, A. & Mikolajczyk, R.T. (2008). Timeliness of vaccination
and its effects on fraction of vaccinated population. Vaccine, 26, 3805-3811.
10 Algra, A., Gijn, J. van, Halkes, P.H.A., Kappelle, L.J. & Koudstaal, P.J. (2008). Interpretation of ESPRIT
in the FASTER trial. Lancet Neurology, 7(3), 198-199.
184 Annual Report 2008
11 Allen, N.E., Key, T.J., Dossus, L., Rinaldi, S., Cust, A., Lukanova, A., Peeters, P.H.M., Onland-Moret, N.C., Lahmann, P.H., Berrino, F., Panico, S., Larranaga, N., Pera, G., Tormo, M.J., Sanchez, M.J.,
Ramon Quiros, J., Ardanaz, E., Tjonneland, A., Olsen, A., Chang-Claude, J., Linseisen, J., Schulz, M.,
Boeing, H., Lundin, E., Palli, D., Overvad, K., Clavel-Chapelon, F., Boutron-Ruault, M.C., Bingham, S,
Khaw, K.T., Bas Bueno-de-Mesquita, H, Trichopoulou, A., Trichopoulos, D., Naska, A., Tumino, R.,
Riboli, E. & Kaaks, R. (2008). Endogenous sex hormones and endometrial cancer risk in women in
the European Prospective Investigation into Cancer and Nutrition (EPIC). Endocrine-related Cancer,
15(2), 485-497.
12 Anti-HIV Drugs, Study Group, Sabin, C.A., Schneider, M.M.E., Bonten, M.J.M., Borleffs, J.C.C.,
Ellerbroek, P.M., Hoepelman, I.M., Jaspers, C.A.J.J., Schurink, C.A.M. & Lundgren, J.D. (2008).
Changes over time in risk factors for cardiovascular disease and use of lipid-lowering drugs in HIV-
infected individuals and impact on myocardial infarction. Clinical Infectious Diseases, 46(7), 1101-
1110.
13 Antonelli, M., Azoulay, E., Bonten, M.J.M., Chastre, J., Citerio, G., Conti, G., De Backer, D., Lemaire,
F., Gerlach, H., Groeneveld, J., Hedenstierna, G, MacRae, D., Mancebo, J., Maggiore, S.M., Mebazaa,
A., Metnitz, P., Pugin, J., Wernerman, J. & Zhang, H. (2008). Year in review in Intensive Care
Medicine, 2007. I. Experimental studies. Clinical studies: brain injury and neurology, renal failure and
endocrinology. Intensive Care Medicine, 34(2), 229-242.
14 Antonelli, M., Azoulay, E., Bonten, M.J.M., Chastre, J., Citerio, G., De Backer, D., Lemaire, F., Gerlach,
H., Groeneveld, J., Hedenstierna, G, MacRae, D., Mancebo, J., Maggiore, S.M., Mebazaa, A., Metnitz,
P., Pugin, J., Wernerman, J. & Zhang, H. (2008). Year in review in Intensive Care Medicine, 2007. II.
Haemodynamics, pneumonia, infections and sepsis, invasive and non-invasive mechanical ventilation,
acute respiratory distress syndrome. Intensive Care Medicine, 34(3), 405-422.
15 Antonelli, M., Azoulay, E., Bonten, M.J.M., Chastre, J., Citerio, G., Conti, G., De Backer, D., Lemaire,
F., Gerlach, H., Groeneveld, J., Hedenstierna, G, MacRae, D., Mancebo, J., Maggiore, S.M., Mebazaa,
A., Metnitz, P., Pugin, J., Wernerman, J. & Zhang, H. (2008). Year in review in Intensive Care
Medicine, 2007. III. Ethics and legislation, health services research, pharmacology and toxicology,
nutrition and paediatrics. Intensive Care Medicine, 34(4), 598-609.
16 Antova, T., Pattenden, S., Brunekreef, B., Heinrich, J., Rudnai, P., Forastiere, F., Luttmann-Gibson, H.,
Grize, L., Katsnelson, B., Moshammer, H., Nikiforov, B., Slachtova, H., Slotova, K., Zlotkowska, R. &
Fletcher, T. (2008). Exposure to indoor mould and children’s respiratory health in the PATY study.
Journal of Epidemiology and Community Health, 62(8), 708-714.
17 Appelman, A.P.A., Graaf, Y. van der, Vincken, K.L., Tiehuis, A.M., Witkamp, T.D., SMART, Study
Group, Algra, A., Doevendans, P.A.F.M., Eikelboom, B.C., Moll, F.L., Grobbee, D.E., Rutten, G.E.H.M., Kappelle, L.J., Visseren, F.L.J., Mali, W.P.T.M. & Geerlings, M.I. (2008). Total cerebral blood
flow, white matter lesions and brain atrophy: the SMART-MR study. Journal of Cerebral Blood Flow
and Metabolism, 28(3), 633-639.
18 Asch, C.J.J. van, Balemans, W.A.F., Rovers, M.M., Schilder, A.G.M. & Ent, C.K. van der (2008). Atopic
disease and exhaled nitric oxide in an unselected population of young adults. Annals of allergy,
asthma & immunology, 100(1), 59-65.
19 Atsma, F., Bartelink, M.E.L., Schouw, Y.T. van der, Kors, J.A. & Grobbee, D.E. (2008). Elevated blood
pressure and electrocardiographic frontal T axis and spatial QRS-T angle changes in postmenopausal
women. Journal of Electrocardiology, 41(4), 360-364.
20 Atsma, F., Schouw, Y.T. van der, Grobbee, D.E., Hoes, A.W. & Bartelink, M.E.L. (2008). No added
value of age at menopause and the lifetime cumulative number of menstrual cycles for cardiovascular
risk prediction in postmenopausal women. International Journal of Cardiology, 130(2), 190-195.
21 Atsma, F., Bartelink, M.E.L., Grobbee, D.E., Rutten, A., Bots, M.L., Prokop, M. & Schouw, Y.T. van der (2008). Reproductive factors, metabolic factors, and coronary artery calcification in older women.
Menopause, 15(5), 899-904.
Publications 185
22 Avest, P.C. ter, Fischer, K., Mancuso, M.E., Santagostino, E., Yuste, V.J., Berg, H.M. van den, Bom, J.G.
van der & On behalf of, the CANAL Study Group (2008). Risk stratification for inhibitor
development at first treatment for severe hemophilia A: a tool for clinical practice. Journal of
Thrombosis and Haemostasis, 6(12), 2048-2054.
23 Baas, A.F., Janssen, K.J.M., Prinssen, M., Buskens, E. & Blankensteijn, J.D. (2008). The Glasgow
Aneurysm Score as a tool to predict 30-day and 2-year mortality in the patients from the Dutch
Randomized Endovascular Aneurysm Management trial. Journal of Vascular Surgery, 47(2), 277-281.
24 Bartelink, I.H., Bredius, R.G., Ververs, F.F.T., Raphael, M.F., Kesteren, C. van, Bierings, M.B.,
Rademaker, C.M.A., Hartigh, J. den, Uiterwaal, C.S.P.M., Zwaveling, J. & Boelens, J.J. (2008). Once-
Daily Intravenous Busulfan with Therapeutic Drug Monitoring Compared to Conventional Oral
Busulfan Improves Survival and Engraftment in Children Undergoing Allogeneic Stem Cel
Transplantation. Biology of blood and marrow transplantation, 14(1), 88-98.
25 Bax, L., Algra, A., Mali, W.P.T.M., Edlinger, M., Beutler, J.J. & Graaf, Y. van der (2008). Renal function
as a risk indicator for cardiovascular events in 3216 patients with manifest arterial disease [Smart
Study Group]. Atherosclerosis, 200(1), 184-190.
26 Beelen, R., Hoek, G., Brandt, P.A. v.d., Goldbohm, R.A., Fischer, P., Schouten, L.J., Jerrett, M., Hughes,
E., Armstrong, B. & Brunekreef, B. (2008). Long-term effects of traffic-related air pollution on
mortality in a Dutch cohort (NLCS-AIR study). Environmental Health Perspectives, 116(2), 196-202.
27 Beelen, R., Hoek, G., Brandt, P.A. v.d., Goldbohm, R.A., Fischer, P., Schouten, L.J., Armstrong, B. &
Brunekreef, B. (2008). Long-term exposure to traffic-related air pollution and lung cancer risk.
Epidemiology, 19(5), 702-710.
28 Beijnum, J. van, Hanlo, P.W., Fischer, K., Majidpour, M.M., Kortekaas, M.F., Verdaasdonk, R.M. &
Vandertop, W.P. (2008). Laser-assisted endoscopic third ventriculostomy: long-term results in a series
of 202 patients. Neurosurgery, 62(2), 437-443.
29 Benders, M.J., Groenendaal, F., Uiterwaal, C.S.P.M. & Vries, L.S. de (2008). Perinatal arterial stroke in
the preterm infant. Seminars in perinatology, 32(5), 344-349.
30 Berg, B. van den, Grievink, L., Velden, P.G. van der, Yzermans, C.J., Stellato, R.K., Lebret, E. &
Brunekreef, B. (2008). Risk factors for physical symptoms after a disaster: a longitudinal study.
Psychological Medicine, 38(4), 499-510.
31 Bergh, W.M. van den, Water, J.M. van de, Hoff, R.G., Algra, A. & Rinkel, G.J.E. (2008). Calcium
homeostasis during magnesium treatment in aneurysmal subarachnoid hemorrhage. Neurocritical
Care, 8(3), 413-417.
32 Besselink, M.G.H., Santvoort, H.C. van, Buskens, E., Boermeester, M.A., Goor, H. van, Timmerman,
H., Nieuwenhuijs, V.B., Bollen, T.L., Ramshorst, B. van, Witteman, B.J., Rosman, C., Ploeg, R.J., Brink,
M., Schaapherder, A.F., Dejong, C.H. van, Wahab, P.J., Laarhoven, C.J.H.M. van, Harst, E. van der,
Eijck, C.H.J. van, Cuesta, M.A., Akkermans, L.M.A. & Gooszen, H.G. (2008). Probiotic prophylaxis in
predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet,
371(9613), 651-659.
33 Besselink, M.G.H., Verwer, T.J., Schoenmaeckers, E.J., Buskens, E., Ridwan, B.U., Visser, M.R.,
Nieuwenhuijs, V.B. & Gooszen, H.G. (2008). Timing of surgical intervention in necrotizing
pancreatitis. Archives of Surgery, 142(12), 1194-1201.
34 Beulens, J.W.J., Kruidhof, J.S., Grobbee, D.E., Chaturvedi, N., Fuller, J.H. & Soedamah-Muthu, S.S
(2008). Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the
EURODIAB Prospective Complications Study. Diabetologia, 31(10), 2050-2055.
35 Beulens, J.W.J., Rimm, E.B., Hu, F.B., Hendriks H.F. & Mukamal, K.J. (2008). Alcohol consumption,
mediating biomarkers, and risk of type 2 diabetes among middle-aged women. Diabetes Care Oct;31
(10):2050-5.
36 Biesheuvel, C.J., Vergouwe, Y., Oudega, R., Hoes, A.W., Grobbee, D.E. & Moons, K.G.M. (2008).
Advantages of the nested case-control design in diagnostic research. BMC Medical Research
Methodology [E], 8(1), 48.
186 Annual Report 2008
37 Biesheuvel, C.J., Vergouwe, Y., Steyerberg, E.W., Grobbee, D.E. & Moons, K.G.M. (2008). Polytomous
logistic regression analysis could be applied more often in diagnostic research. Journal of Clinical
Epidemiology, 61(2), 125-134.
38 Bijkerk, C.J., Muris, J.W.M., Knottnerus, J.A., Hoes, A.W. & Wit, N.J. de (2008). Randomised patients
in irritable bowel syndrome research had different disease characteristics compared to eligible an
recruited patients. Journal of Clinical Epidemiology, 61(11), 1176-1181.
39 Bijlsma, J.W.J. & Welsing, P.M.J. (2008). The art of medicine in treating osteoarthritis: I will please.
Annals of the Rheumatic Diseases, 67(12), 1653-1655.
40 Bollen, C.W., Vught, A.J. van & Uiterwaal, C.S.P.M. (2008). High-frequency ventilation is/is not the
optimal physiological approach to ventilate ARDS patients. Journal of Applied Physiology, 104(4),
1238.
41 Bolt, L.L.E., Kalis, A., Derijks, H.J. & Delden, J.J.M. van (2008). Ethical questions in the field of
pharmacogenetics. European Journal of Hospital Pharmacy Practice, 14(1), 30-34.
42 Bont, J., Hoes, A.W., Macfarlane, J.T., Verheij, Th.J.M. & Hak, E. (2008). Predicting death in elderly
patients with community-acquired pneumonia: a prospective validation study reevaluating the CRB-
65 severity assessment tool. Archives of Internal Medicine, 168(13), 1465-1468.
43 Boonacker, C.W.B., Veen, E.L. van der, Wilt, G.J. van der, Schilder, A.G.M. & Rovers, M.M. (2008).
Trimethoprim-Sulfamethoxazole in Children With Chronic Otitis Media: A Randomized Comparison
of Costs and Effects. Otology & Neurotology, 29(7), 961-964.
44 Bor, A.S.E., Rinkel, G.J.E., Adami, J., Koffijberg, H., Ekbom, A., Buskens, E., Blomqvist, P. & Granath,
F. (2008). Risk of subarachnoid haemorrhage according to number of affected relatives: a population
based case–control study. Brain, 131(10), 2662-2665.
45 Bosman, M. & Meijel, B. van (2008). Perspectives of mental health professionals and patients on self-
injury in psychiatry: a literature review. Archives of psychiatric nursing, 22(4), 180-189.
46 Bottema, R.W.B., Reijmerink, N.E., Kerkhof, M., Koppelman, G.H., Stelma, F.F., Gerritsen, J., Thijs, C.,
Brunekreef, B., Schayck, C.P. van & Postma, D.S. (2008). Interleukin 13, CD14, pet and tobacco
smoke influence atopy in three Dutch cohorts: the allergenic study. European Respiratory Journal,
32(3), 593-602.
47 Bozkurt, O., Verschuren, W.M.M., Wieren-de Wijer, B.M.A. van, Knol, M.J., Boer, A. de, Grobbee, D.E., Geerlings, M.I., Heerdink, E.R. & Klungel, O.H. (2008). Genetic variation in the renin-
angiotensin system modifies the beneficial effects of ACE inhibitors on the risk of diabetes mellitus
among hypertensives. Journal of human hypertension, 22, 774-780.
48 Britton, J.A., Khan, A.E., Rohrmann, S., Becker, N., Linseisen, J., Nieters, A., Kaaks, R., Tjonneland, A.,
Halkjaer, J., Severinsen, M.T., Overvad, K., Pischon, T., Boeing, H., Trichopoulou, A., Kalapothaki, V.,
Trichopoulos, D., Mattiello, A., Tagliabue, G., Sacerdote, C., Peeters, P.H.M., Bueno-de-Mesquita,
H.B., Ardanaz, E., Navarro, C., Jakszyn, P., Altzibar, J.M., Hallmans, G., Malmer, B., Berglund, G.,
Manjer, J., Allen, N., Key, T.J., Bingham, S, Besson, H., Ferrari, P., Jenab, M., Boffetta, P., Vineis, P. &
Riboli, E. (2008). Anthropometric characteristics and non-Hodgkin’s lymphoma and multiple
myeloma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Haematologica, 93(11), 1666-1677.
49 Bruggen, J.A.R. van, Gorter, K.J., Stolk, R.P., Verhoeven, R.P. & Rutten, G.E.H.M. (2008).
Implementation of locally adapted guidelines on type 2 diabetes. Results of a cluster randomised trial
in primary care. Family Practice, 25(6), 430-437.
50 Bruggen, J.A.R. van, Gorter, K.J., Stolk, R.P. & Rutten, G.E.H.M. (2008). Overall quality of diabetes
care in a defined geographic region: different sides of the same story. British Journal of General
Practice, 58, 39-345.
51 Bruijn, C. de, Bie, R. de, Geraets, J., Goossens, M., Heuvel, W. van den, Heijden, G.J.M.G. van der,
Candel, M. & Dinant, G.J. (2008). Effect of an education and activation programme on functional
limitations and patient-perceived recovery in acute and sub-acute shoulder complaints - A
randomised clinical trial. BMC Musculoskeletal Disorders [E], 8, 112.
Publications 187
52 Bruins Slot, M.H.E., Heijden, G.J.M.G. van der, Rutten, F.H., Spoel, O.P. van der, Mast, E., Bredero,
A.C., Doevendans, P.A., Glatz, J.F.C. & Hoes, A.W. (2008). Heart-type Fatty acid-binding protein in
Acute Myocardial infarction Evaluation (FAME) : background and design of a diagnostic study in
primary care. BMC Cardiovascular Disorders [E], 15(8), 8.
53 Brunekreef, B. & Maynard, R.L. (2008). A note on the 2008 EU standards for particulate matter.
Atmospheric Environment, 42(26), 6425-6430.
54 Brunekreef, B. (2008). Environmental epidemiology and risk assessment. Toxicology Letters, 180(2),
118-122.
55 Bruns, A.H.W., Oosterheert, J.J., Hak, E. & Hoepelman, A.I.M. (2008). Usefulness of consecutive
C-reactive protein measurements in follow-up of severe community-acquired pneumonia. European
Respiratory Journal, 32(3), 726-732.
56 Brussel, M. van, Takken, T., Uiterwaal, C.S.P.M., Pruijs, J.E.H., Net, J. van der, Helders, P.J.M. &
Engelbert, R.H.H. (2008). Physical Training in Children with Osteogenesis Imperfecta. The Journal of
Pediatrics, 152(1), 111-116.el.
57 Buiting, H.M., Rietjens, J.A.C., Onwuteaka-Philipsen, B.D., Maas, P.J. van der, Delden, J.J.M. van &
Heide, A. van der (2008). A comparison of physicians’ end-of-life decision-making for non-western
migrants and Dutch natives in the Netherlands. European Journal of Public Health, 18(6), 681-687.
58 Buiting, H.M., Gevers, J.K.M., Rietjens, J.A.C., Onwuteaka-Philipsen, B.D., Maas, P.J. van der, Heide,
A. van der & Delden, J.J.M. van (2008). Dutch criteria of due care for physician-assisted dying in
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59 Capella, G., Pera, G., Sala, N., Agudo, A., Rico, F., Giudicce, G. del, Plebani, M., Palli, D., Boeing, H.,
Bueno-de-Mesquita, H.B., Carneiro, F., Berrino, F., Vineis, P., Tumino, R., Panico, S., Berglund, G.,
Siman, H., Nyren, O., Hallmans, G., Martinez, C., Dorronsoro, M., Barricarte, A., Navarro, C., Quiros,
J.R., Allen, N., Key, T.J., Bingham, S., Caldas, C., Linseisen, J., Nagel, G., Overvad, K., Tjonneland, A.,
Boshuizen, H.C., Peeters, P.H.M., Numans, M.E., Clavel-Chapelon, F., Trichopoulou, A., Lund, E.,
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60 Chavez-MacGregor, M., Gils, C.H. van, Schouw, Y.T. van der, Monninkhof, E.M., Noord, P.A.H. van
& Peeters, P.H.M. (2008). Lifetime cumulative number of menstrual cycles and serum sex hormone
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61 Chen, C.M., Gehring, U., Wickman, M., Hoek, G., Giovannangelo, M., Nordling, E., Wijga, A., Jongste,
J.C. de, Pershagen, G., Almqvist, C., Kerkhof, M., Bellander, T., Wichmann, H.E., Brunekreef, B. &
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62 Cleveringa, F.G.W., Gorter, K.J., Donk, M. van den & Rutten, G.E.H.M. (2008). Combined task
delegation, computerized decision support and feedback information improve cardiovascular risk for
type 2 diabetes patients. A cluster randomized trial in primary care. Diabetes Care, 31(12), 2273-
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63 Coenen, S., Ferech, M., Haaijer-Ruskamp, F.M., Butler, C.C., Vander Stichele, R.H., Verheij, Th.J.M., Monnet, D.L., Little, P. & Goossens, H.H.L.M. (2008). European Surveillance of Antimicrobial
Consumption (ESAC): Kwaliteitsindicatoren voor het antibioticagebruik in de ambulante praktijk.
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64 Cohen, J., Delden, J.J.M. van, Mortier, F., Löfmark, R., Norup, M., Cartwright, C., Faisst, K., Canova,
C., Onwuteaka-Philipsen, B.D. & Bilsen, J. (2008). Influence of physicians’ life stances on attitudes to
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65 Colvin, B.T., Astermark, J., Fischer, K., Gringeri, A., Lassila, R., Schramm, W., Thomas, A. & Ingerslev,
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188 Annual Report 2008
66 Compter, A., Worp, H.B. van der, Schonewille, W.J., Vos, J.A., Algra, A., Lo, T.H., Mali, W.P.T.M., Moll,
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67 Cox, D.G., Bretsky, P., Kraft, P., Pharoah, P., Albanes, D., Altshuler, D., Amiano, P., Berglund, G.,
Boeing, H., Buring, J.E., Burtt, N.P., Calle, E.E., Canzian, F., Chanock, S., Clavel-Chapelon, F., Colditz,
G., Feigelson, H.S., Haiman, C.A., Hankinson, S.E., Hirschhorn, J.N., Henderson, B.E., Hoover, R.,
Hunter, D.J., Kaaks, R., Kolonel, L.N., LeMarchand, L., Lund, E., Palli, D., Peeters, P.H.M., Pike, M.C.,
Riboli, E., Stram, D.O., Thun, M.J., Tjonneland, A., Travis, R.C., Trichopoulos, D. & Yeager, M. (2008).
Haplotypes of the estrogen receptor beta gene and breast cancer risk. International Journal of Cancer,
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68 Crusius, J.B.A., Canzian, F., Capella, G., Peña, A.S., Pera, G., Sala, N., Agudo, A, Rico, F., Giudice, G.
del, Palli, D., Plebani, M., Boeing, H., Bueno-de-Mesquita, H.B., Carneiro, F., Pala, V., Save, V., Vineis,
P., Tumino, R., Panico, S., Berglund, G., Manjer, J., Stenling, R., Hallmans, G., Martinez, C.,
Dorronsoro, M., Barricarte, A., Navarro, C., Quiros, J.R., Allen, N., Key, T.J., Bingham, S., Caldas, C.,
Linseisen, J., Kaaks, R., Overvad, K., Tjonneland, A., Büchner, F.C., Peeters, P.H., Numans, M.E., Clavel-Chapelon, F., Trichopoulos, A., Lund, E., Jenab, M., Rinaldi, S., Ferrari, P., Riboli, E. &
Gonzalez, C.A. (2008). Cytokine gene polymorphisms and the risk of adenocarcinoma of the stomach
in the European prospective investigation into cancer and nutrition (EPIC-EURGAST). Annals of
Oncology, 19(11), 1894-1902.
69 Cummings, S.R., Ettinger, B., Delmas, P.D., Kenemans, P., Stathopoulos, V., Verweij, P., Mol-Arts, M.,
Kloosterboer, L., Mosca, L., Christiansen, C., Bilezikian, J.P., Kerzberg, E.M., Johnson, S., Zanchetta, J.,
Grobbee, D.E., Diest, P.J. van, Seifert, W., Eastell, R. & LIFT Trial, Invest. (2008). The effects of
tibolone in older postmenopausal women [for the LIFT Trial Investigators]. New England Journal of
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70 D.A.D., Study Group, Sabin, C.A., Schneider, M.M.E., Bonten, M.J.M., Borleffs, J.C.C., Ellerbroek,
P.M., Hoepelman, I.M., Jaspers, C.A.J.J., Schurink, C.A.M. & Lundgren, J.D. (2008). Use of nucleoside
reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients enrolled in
the D:A:D study: a multi-cohort collaboration. Lancet, 371(9622), 1417-1426.
71 Dalmeijer, G.W., Olthof, M., Verhoef, P., Bots, M.L. & Schouw, Y.T. van der (2008). Prospective study
on dietary intakes of folate, betaine, and choline and cardiovascular disease risk in women. European
Journal of Clinical Nutrition, 62(3), 386-394.
72 Davis, S.A., Trapman, J.P., Leirs, H., Begon, M. & Heesterbeek, J.A.P. (2008). The abundance threshold
for plague as a critical percolation phenomenon. Nature, 454(7204), 634-637.
73 Delden, J.J.M. van, Ashcroft, R., Dawson, A., Marckmann, G., Upshur, R. & Verweij, M.F. (2008). The
ethics of mandatory vaccination against influenza for health care workers. Vaccine, 26(44), 5562-5566.
74 Deurzen, C.H.M. van, Boer, M. de, Monninkhof, E.M., Bult, P., Wall, E. van der, Tjan-Heijnen, V.C. &
Diest, P.J. van (2008). Non-sentinel lymph node metastases associated with isolated breast cancer cells
in the sentinel node. Journal of the National Cancer Institute, 100(22), 1574-1580.
75 Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J.J., Ponikowski, P., Poole-Wilson, P.A.,
Strömberg, A., Veldhuisen, D.J. van, Atar, D., Hoes, A.W., Keren, A., Mebazaa, A., Nieminen, M.,
Priori, S.G., Swedberg, K, Vahanian, A., Camm, J., Caterina, R. De, Dean, V., Funck-Brentano, C.,
Hellemans, I., Kristensen, S.D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P. &
Zamorano, J.L. (2008). ESC guidelines for the diagnosis and treatment of acute and chronic heart
failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of
the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of
the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM).
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76 Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J.J., Ponikowski, P., Poole-Wilson, P.A.,
Strömberg, A., Veldhuisen, D.J. van, Atar, D., Hoes, A.W., Keren, A., Mebazaa, A., Nieminen, M.,
Priori, S.G., Swedberg, K, Vahanian, A., Camm, A.J., Caterina, R. De, Dean, V., Funck-Brentano, C.,
Hellemans, I.M., Kristensen, S.D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P.,
Zamorano, J.L., Tendera, M., Auricchio, A., Bax, J., Böhm, M., Corrà, U., Bella, P. della, Elliott, P.M,
Follath, F., Gheorghiade, M., Hasin, Y., Hernborg, A., Jaarsma, T., Komajda, M., Kornowski, R.,
Piepoli, M., Prendergast, B., Tavazzi, L., Vachiery, J.L., Verheugt, F.W.A., Zarnorano, J.L. & Zannad, F.
(2008). ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the
Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European
Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC
(HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). European Journal
of Heart Failure, 10(10), 933-989.
77 Dijk, D. van, Moons, K.G.M., Nathoe, H.M., Aarnhem, E.E.H.L. van, Borst, C., Keizer, A.M.A.,
Kalkman, C.J. & Hijman, R. (2008). Cognitive Outcomes Five Years After Not Undergoing Coronary
Artery Bypass Graft Surgery. Annals of Thoracic Surgery, 85(1), 60-64.
78 Dijkema, M.B.A., Zee, S.C. van der, Brunekreef, B. & Strien, R.T. van (2008). Air quality effects of an
urban highway speed limit reduction. Atmospheric Environment, 42(40), 9098-9105.
79 Dijkema, T., Terhaard, C.H.J., Roesink, J.M., Braam, P.M., Gils, C.H. van, Moerland, M.A. &
Raaijmakers, C.P.J. (2008). Large Cohort Dose-Volume Response Analysis of Parotid Gland Function
After Radiotherapy: Intensity-Modulated VERSUS Conventional Radiotherapy. International Journal
of Radiation Oncology Biology Physics, 72(4), 1101-1109.
80 Disseldorp, J. van, Faddy, M.J., Themmen, A.P.N., Jong, F.H. de, Peeters, P.H.M., Schouw, Y.T. van der
& Broekmans, F.J.M. (2008). Relationship of serum antimüllerian hormone concentration to age at
menopause. Journal of Clinical Endocrinology and Metabolism, 93(6), 2129-2134.
81 Disseldorp, J. van, Broekmans, F.J.M., Peeters, P.H., Fauser, B.C.J.M. & Schouw, Y.T. van der (2008).
The association between vascular function-related genes and age at natural menopause. Menopause,
15(3), 511-516.
82 Dool, C. van den, Strien, A.M. van, Akker, I.L. den, Bonten, M.J.M., Sanders, E.A.M. & Hak, E. (2008).
Attitude of Dutch hospital personnel towards influenza vaccination. Vaccine, 26(10), 1297-1302.
83 Dool, C. van den, Hak, E., Wallinga, J., Loon, A.M. van, Lammers, J.W.J. & Bonten, M.J.M. (2008).
Symptoms of influenza virus infection in hospitalized patients. Infection control and hospital
epidemiology, 29(4), 314-319.
84 Dool, C. van den, Bonten, M.J.M., Hak, E., Heijne, J.C. & Wallinga, J. (2008). The effects of influenza
vaccination of health care workers in nursing homes: insights from a mathematical model. PLoS
medicine, 5(10), e200.
85 Dorhout Mees, S.M., Bergh, W.M. van den, Algra, A. & Rinkel, G.J.E. (2008). Antiplatelet therapy in
aneurysmal subarachnoid hemorrhage. Stroke, 39, 2186-2187.
86 Dorhout Mees, S.M., Rinkel, G.J.E., Feigin, V.L., Algra, A., Bergh, W.M. van den, Vermeulen, M. &
Gijn, J. van (2008). Calcium antagonists for aneurysmal subarachnoid hemorrhage. Stroke, 39(2),
514-515.
87 Dorhout Mees, S.M., Algra, A. & Mash-II, Study Group (2008). Magnesium in aneurysmal
subarachnoid hemorrhage (MASH II) phase III clinical trial MASH-II study group. International
Journal of Stroke, 3(1), 63-65.
190 Annual Report 2008
88 Dossus, L., McKay, J.D., Canzian, F., Wilkening, S., Rinaldi, S., Biessy, C., Olsen, A., Tjonneland, A.,
Jakobsen, M.U., Overvad, K., Clavel-Chapelon, F., Boutron-Ruault, M.C., Fournier, A., Linseisen, J.,
Lukanova, A., Boeing, H., Fisher, E., Trichopoulou, A., Georgila, C., Trichopoulos, D., Palli, D., Krogh,
V., Tumino, R., Vineis, P., Quiros, J.R., Sala, N., Martinez-Garcia, C., Dorronsoro, M., Chirlaque, M.D.,
Barricarte, A., Duijnhoven, F.J.B van, Bueno-de-Mesquita, H.B., Gils, C.H. van, Peeters, P.H.M., Hallmans, G., Lenner, P., Bingham, S, Khaw, K.T., Key, T.J., Travis, R.C., Ferrari, P., Jenab, M., Riboli, E.
& Kaaks, R. (2008). Polymorphisms of genes coding for ghrelin and its receptor in relation to
anthropometry, circulating levels of IGF-I and IGFBP-3, and breast cancer risk: a case-control study
nested within the European Prospective Investigation into Cancer and Nutrition (EPIC).
Carcinogenesis, 29(7), 1360-1366.
89 Dungen, C. van den, Hoeymans, N., Gijsen, R., Akker, M. van den, Boesten, J., Smeets, H.M., Veen,
W.J. van der, Verheij, R., Waal, M. de, Schellevis, F. & Westert, G.P. (2008). What factors explain the
differences in morbidity estimations among general practice registration networks in the
Netherlands? A First analysis. European Journal of General Practice, 14(suppl 1), 53-62.
90 Eck, J.W.M. van, Hemel, N.M. van, Kelder, J.C., Bos, A.A. van den, Taks, W., Grobbee, D.E. & Moons, K.G.M. (2008). Poor health-related quality of life of patients with indication for chronic cardiac
pacemaker therapy. PACE-Pacing and Clinical Electrophysiology, 31(4), 480-486.
91 Eck, J.W.M. van, Hemel, N.M. van, Bos, A. van den, Taks, W., Grobbee, D.E. & Moons, K.G.M. (2008). Predictors of improved quality of life 1 year after pacemaker implantation. American Heart
Journal, 156(3), 491-497.
92 Eck, J.W.M. van, Hemel, N.M. van, Voogt, W.G. de, Meeder, M., Spierenburg, H.A., Crommentuyn,
H., Keijzer, R., Grobbee, D.E. & Moons, K.G.M. (2008). Routine follow-up after pacemaker
implantation: frequency, pacemaker programming and professionals in charge. Europace, 10(7), 832-
837.
93 Ege, M.J., Herzum, I., Buchele, G., Krauss-Etschmann, S., Lauener, R.P., Roponen, M., Hyvarinen, A.,
Vuitton, D.A., Riedler, J., Brunekreef, B., Dalphin, J.C., Braun-Fahrlander, C., Pekkanen, J., Renz, H. &
von Mutius, E. (2008). Prenatal exposure to a farm environment modifies atopic sensitization at birth.
Journal of Allergy and Clinical Immunology, 122(2), 407-412.e1-4.
94 Ege, M.J., Herzum, I., Buchele, G., Krauss-Etschmann, S., Lauener, R.P., Bitter, S., Roponen, M.,
Remes, S., Vuitton, D.A., Riedler, J., Brunekreef, B., Dalphin, J.C., Braun-Fahrlander, C., Pekkanen, J.,
Renz, H. & von Mutius, E. (2008). Specific IgE to allergens in cord blood is associated with maternal
immunity to Toxoplasma gondii and rubella virus. Allergy, 63(11), 1505-1511.
95 Ekkelenkamp, M.B., Bruggen, T. van der, Vijver, D.A.M.C. van de, Wolfs, T.F.W. & Bonten, M.J.M. (2008). Bacteremic Complications of Intravascular Catheters Colonized with Staphylococcus aureus.
Clinical Infectious Diseases, 46, 114-118.
96 El Fakiri, F., Bruijnzeels, M.A., Foets, M.M. & Hoes, A.W. (2008). Different distribution of
cardiovascular risk factors according to ethnicity: a study in a high risk population. Journal of
Immigrant and Minority Health, 10(6), 559-565.
97 El Fakiri, F., Bruijnzeels, M.A., Uitewaal, P.J.M., Frenken, R.A., Berg, M. & Hoes, A.W. (2008).
Intensified preventive care to reduce cardiovascular risk in healthcare centres located in deprived
neighbourhoods: a randomized controlled trial. European Journal of Cardiovascular Prevention and
Rehabilitation, 15(4), 488-493.
98 El Fakiri, F., Hoes, A.W., Uitewaal, P.J., Frenken, R.A. & Bruijnzeels, M.A. (2008). Process evaluation of
an intensified preventive intervention to reduce cardiovascular risk in general practices in deprived
neighbourhoods. European Journal of Cardiovascular Nursing, 7(4), 296-302.
99 Elden, L.J.R. van, Sachs, A.P.E., Loon, A.M. van, Haarman, M., Vijver, D.A.M.C. van de, Kimman,
T.G., Zuithoff, P., Schipper, P.J., Verheij, Th.J.M. & Nijhuis, M. (2008). Enhanced severity of virus
associated lower respiratory tract disease in asthma patients may not be associated with delayed viral
clearance and increased viral load in the upper respiratory tra. Journal of Clinical Virology, 41(2),
116-121.
Publications 191
100 Eller, E., Roll, S., Chen, C.M., Herbarth, O., Wichmann, H.E., von Berg, A., Kramer, U., Mommers, M.,
Thijs, C., Wijga, A., Brunekreef, B., Fantini, M.P., Bravi, F., Forastiere, F., Porta, D., Sunyer, J., Torrent,
M., Host, A., Halken, S., Lodrup Carlsen, K.C., Carlsen, K.H., Wickman, M., Kull, I., Wahn, U.,
Willich, S.N., Lau, S., Keil, T. & Heinrich, J. (2008). Meta-analysis of determinants for pet ownership
in 12 European birth cohorts on asthma and allergies: a GA2LEN initiative. Allergy, 63(11), 1491-
1498.
101 Emmelot-Vonk, M.H., Verhaar, H.J.J., Nakhai Pour, H.R., Aleman, A., Lock, M.T.W.T., Bosch,
J.L.H.R., Grobbee, D.E. & Schouw, Y.T. van der (2008). Effect of testosterone supplementation on
functional mobility, cognition, and other parameters in older men: a randomized controlled trial.
JAMA - The Journal of The American Medical Association, 299(1), 39-52.
102 Essen, G.A. van (2008). Influenza vaccination of healthcare workers, oseltamivir resistance and
prepandemic vaccination. Expert Review of Respiratory Medicine, 2, 703-705.
103 Esser, S. van, Hobbelink, M.G.G., Peeters, P.H.M., Buskens, E., Ploeg, I.M. van der, Mali, W.P.T.M.,
Borel Rinkes, I.H.M. & Hillegersberg, R. van (2008). The efficacy of ‘Radio guided Occult Lesion
Localization’ (ROLL) versus ‘Wire-guided Localization’ (WGL) in breast conserving surgery for non-
palpable breast cancer: a randomized clinical trial - ROLL study. BMC Surgery [E], 8(1), 9-9.
104 Fioole, B., Haas, R.J. de, Wicherts, D.A., Elias, S.G., Scheffers, J.M., Hillegersberg, R. van, Leeuwen,
M.S. van & Borel Rinkes, I.H.M. (2008). Additional value of contrast enhanced intraoperative
ultrasound for colorectal liver metastases. European Journal of Radiology, 67(1), 169-176.
105 Fischer, K. (2008). Can we consider discontinuing primary prophylaxis in adults with severe
haemophilia? Haemophilia, 14(S4), 10-10.
106 Fischer, K., Valentino, L., Ljungs, R. & Blanchette, V. (2008). Prophylaxis for severe haemophilia:
clinical challenges in the absence as well as in the presence of inhibitors. Haemophilia, 14(S3), 196-
201.
107 Flohr, C., Weiland, S.K., Weinmayr, G., Bjorksten, B., Braback, L., Brunekreef, B., Buchele, G.,
Clausen, M., Cookson, W.O., von Mutius, E., Strachan, D.P. & Williams, H.C. (2008). The role of
atopic sensitization in flexural eczema: findings from the International Study of Asthma and Allergies
in Childhood Phase Two. Journal of Allergy and Clinical Immunology, 121(1), 141-147.e4.
108 Fluttert, F.A.J., Meijel, B.K.G. van, Webster, C., Nijman, H., Bartels, A. & Grypdonck, M.H.F. (2008).
Risk management by early recognition of warning signs in patients in forensic psychiatric care.
Archives of psychiatric nursing, 22(4), 208-216.
109 Fonville, S., Worp, H.B. van der, Maat, P., Aldenhoven, M., Algra, A. & Gijn, J. van (2008). Accuracy
and inter-observer variation in the classification of dysarthria from speech recordings. Journal of
Neurology, 255, 1545-1548.
110 Furnee, E.J.B., Draaisma, W.A., Broeders, I.A.M.J., Smout, A.J.P.M., Vlek, A.L.M. & Gooszen, H.G.
(2008). Predictors of symptomatic and objective outcomes after surgical reintervention for failed
antireflux surgery. British Journal of Surgery, 95(11), 1369-1374.
111 Gast, G.C.M., Grobbee, D.E., Pop, V.J., Keyzer, J.J., Wijnands-van Gent, C.J., Samsioe, G., Nilsson, P. &
Schouw, Y.T. van der (2008). Menopausal complaints are associated with cardiovascular risk factors.
Hypertension, 51(6), 1492-1498.
112 Geerlings, M.I., Heijer, T. den, Koudstaal, P.J., Hofman, A. & Breteler, M.M. (2008). History of
depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer
disease. Neurology, 70(15), 1258-1264.
113 Geerts, C.C., Bots, M.L., Grobbee, D.E. & Uiterwaal, C.S.P.M. (2008). Parental smoking and vascular
damage in young adult offspring: is early life exposure critical? The atherosclerosis risk in young
adults study. Arteriosclerosis, Thrombosis and Vascular Biology, 28(12), 2296-2302.
192 Annual Report 2008
114 Gehring, U., Strikwold, M., Schram-Bijkerk, D., Weinmayr, G., Genuneit, J., Nagel, G., Wickens, K.,
Siebers, R., Crane, J., Doekes, G., Di Domenicantonio, R., Nilsson, L., Priftanji, A., Sandin, A., El-
Sharif, N., Strachan, D., Hage, M. van, von Mutius, E. & Brunekreef, B. (2008). Asthma and allergic
symptoms in relation to house dust endotoxin: Phase Two of the International Study on Asthma and
Allergies in Childhood (ISAAC II). Clinical and Experimental Allergy, 38(12), 1911-1920.
115 Gehring, U., Spithoven, J., Schmid, S., Bitter, S., Braun-Fahrlander, C., Dalphin, J.C., Hyvarinen, A.,
Pekkanen, J., Riedler, J., Weiland, S.K., Buchele, G., von Mutius, E., Vuitton, D.A. & Brunekreef, B. (2008). Endotoxin levels in cow’s milk samples from farming and non-farming families - the
PASTURE study. Environment International, 34(8), 1132-1136.
116 Gent, R. van, Meer, G. de, Rovers, M.M., Kimpen, J.L.L., Ent, C.K. van der & Essen, L.E van (2008).
Adherence to follow-up recommendations in asthma. Archives of Disease in Childhood, 93(3), 236-
238.
117 Gestel, J.P.J. van, Bollen, C.W., Tweel, I. van der, Boelens, J.J. & Vught, A.J. van (2008). Intensive care
unit mortality trends in children after hematopoietic stem cell transplantation: a meta-regression
analysis. Critical Care Medicine, 36(10), 2898-2904.
118 Goessens, B.M.B., Visseren, F.L.J., Nooijer, J. de, Borne, H.W. van den, Algra, A., Wierdsma, J. &
Graaf, Y. van der (2008). A pilot-study to identify the feasebility of an internet-based coaching
programme for changing to vascular risk profile of high-risk patients [Smart Study Group]. Patient
Education and Counseling, 73(1), 67-72.
119 Gorter, P.M., Visseren, F.L.J., Moll, F.L., Graaf, Y. van der & SMART, Study Group (2008). Intra-
abdominal fat and metabolic syndrome are associated with larger infrarenal aortic diameters in
patients with clinically evident arterial disease. Journal of Vascular Surgery, 48(1), 114-120.
120 Gorter, P.M., Lindert, A.S.R. van, Vos, A.M. de, Meijs, M.F.L., Graaf, Y. van der, Doevendans, P.A.F.M.,
Prokop, W.M. & Visseren, F.L.J. (2008). Quantification of epicardial and peri-coronary fat using
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128 Groot, E. de, Leuven, S.I. van, Duivenvoorden, R., Meuwese, M., Akdim, F., Bots, M.L. & Kastelein, J.J.
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129 Groot, J.A.H. de, Janssen, K.J.M., Zwinderman, A.H., Moons, K.G.M. & Reitsma, J.B. (2008). Multiple
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130 Hack, K.E.A., Derks, J.B., Elias, S.G., Franx, A., Roos, E.J., Voerman, S.K., Bode, C.L., Esseboom, C. &
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131 Hack, K.E.A., Nikkels, P.G.J., Esseboom, C., Derks, J.B., Elias, S.G., Gemert, MJ van & Visser, G.H.A.
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132 Hack, K.E.A., Kaandorp, J.J., Derks, J.B., Elias, S.G., Pistorius, L.R. & Visser, G.H.A. (2008). The value
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134 Hak, E., Sanders, E.A.M., Verheij, Th.J.M., Huijts, S.M., Gruber, W., Tansey, S., McDonough, A.,
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135 Halkes, P.H.A., Gray, L.J., Bath, P.M., Diener, H.-C., Guiraud-Chaumeil, B., Yatsu, F. & Algra, A. (2008). Dipyridamole plus aspirin in secondary prevention after transient ischemic attack or stroke of
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136 Havenaar, J.M., Geerlings, M.I., Vivian, L., Collinson, M.E. & Robertson, B. (2008). Common mental
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137 Hecke, A. van, Grypdonck, M.H.F. & Defloor, T. (2008). Interventions to enhance patient compliance
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138 Heikens, E., Schaik, W. van, Laevis, H.L., Bonten, M.J.M. & Willems, R.J.L. (2008). Identification of a
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139 Helgadottir, A., Thorleifsson, G., Magnusson, K.P., Gretarsdottir, S., Steinthorsdottir, V., Manolescu,
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M.P., Austin, H., Levey, A.I., Vaccarino, V, Palsdottir, E., Walters, G.B., Jonsdottir, T., Snorradottir, S.,
Magnusdottir, D., Gudmundsson, G., Ferrell, R.E., Sveinbjornsdottir, S., Hernesniemi, J., Niemela, M.,
Limet, R.V., Andersen, K., Sigurdsson, G., Benediktsson, R., Verhoeven, E.L., Teijink, J.A., Grobbee, D.E., Rader, D.J., Collier, D.A., Pedersen, O., Pola, R., Hillert, J., Lindblad, B., Valdimarsson, E.M.,
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140 Hendrickx, A.P.A., Bonten, M.J.M., Luit-Asbroek, M. van, Schapendonk, C.M., Kragten, A.H. &
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141 Hertog, H.M. den, Worp, H.B. van der, Gemert, H.M. van, Algra, A., Kappelle, L.J., Gijn, J. van,
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142 Hertogh, E.M., Monninkhof, E.M., Schouten, E.G., Peeters, P.H.M. & Schuit, A.J. (2008). Validity of
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143 Heuven, A.W. van, Dorhout Mees, S.M., Algra, A. & Rinkel, G.J.E. (2008). Validation of a prognostic
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144 Himbergen, T.M. van, Schouw, Y.T. van der, Voorbij, H.A.M., Tits, L.J. van, Stalenhoef, A.F., Peeters, P.H.M. & Roest, M. (2008). Paraoxonase (PON1) and the risk for coronary heart disease and
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145 Ho, V.K., Heiden-van der Loo, M. van der, Rutgers, E.J., Diest, P.J. van, Hobbelink, M.G.G., Tjan-
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146 Hoff, R.G., Dijk, G.W. van, Algra, A., Kalkman, C.J. & Rinkel, G.J.E. (2008). Fluid balance and blood
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147 Hoff, R.G., Dijk, G.W. van, Mettes, S., Verweij, B.H., Algra, A., Rinkel, G.J.E. & Kalkman, C.J. (2008).
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148 Hoff, R.G., Rinkel, G.J.E., Verweij, B.H., Algra, A. & Kalkman, C.J. (2008). Nurses prediction of
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149 Hofhuis, J.G., Spronk, P.E., Stel, H.F. van & Schrijvers, A.J.P. (2008). Experiences of critically ill
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150 Hofhuis, J.G., Spronk, P., Stel, H.F. van, Schrijvers, A.J.P., Rommes, J. & Bakker, P.J. (2008). The
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151 Hofhuis, J.G., Spronk, P.E., Stel, H.F. van, Schrijvers, A.J.P., Rommes, J.H. & Bakker, J. (2008). The
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152 Hofmeijer, J., Anema, P.C. & Tweel, I. van der (2008). New algorithm for treatment allocation reduced
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153 Hofmeijer, J., Algra, A., Kappelle, L.J. & Worp, H.B. van der (2008). Predictors of life-threatening
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154 Howard, S.C., Algra, A. & Rothwell, P.M. (2008). Effect of age and glycaemic control on the
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155 Huijbregts, H.J.T.A.M., Bots, M.L., Wittens, C.H.A., Schrama, Y.C., Moll, F.L. & Blankestijn, P.J.
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156 Ista, E., Dijk, M. van, Gamel, C.J., Tibboel, D. & Hoog, M. (2008). Withdrawal symptoms in critically
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157 Jaarsma, T., Wal, M.H. van der, Lesman-Leegte, I, Luttik, M.L., Hogenhuis, J., Veeger, N.J., Sanderman,
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158 Jabaaij, L., Fassaert, Th., Dulmen, S van, Timmermans, A., Essen, G.A. van & Schellevis, F. (2008).
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159 Jacobs, P.C.A., Mali, W.P.T.M., Grobbee, D.E. & Graaf, Y. van der (2008). Prevalence of incidental
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160 Jacobsen, D.E., Samson, M.M., Schouw, Y.T. van der, Grobbee, D.E. & Verhaar, H.J.J. (2008). Efficacy
of tibolone and raloxifene for the maintenance of skeletal muscle strength, bone mineral density,
balance, body composition, cognitive function, mood/depression, anxiety and quality of life/well-
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161 Jaddoe, V.W., Ridder, M.A. de, Elzen, A.P. van den, Hofman, A., Uiterwaal, C.S.P.M. & Witteman, J.C.
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162 Janse, A.J., Sinnema, G., Uiterwaal, C.S.P.M., Kimpen, J.L.L. & Gemke, R.J.B.J. (2008). Quality of life
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163 Jansen, A.G.S.C., Sanders, E.A.M., Smulders, S., Hoes, A.W. & Hak, E. (2008). Adverse reactions to
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164 Jansen, A.G.S.C., Sanders, E.A.M., Nichol, K.L., Loon, A.M. van, Hoes, A.W. & Hak, E. (2008).
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165 Jansen, A.G.S.C., Sanders, E.A.M., Hoes, A.W., Loon, A.M. van & Hak, E. (2008). Effects of influenza
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166 Jansen, A.G.S.C., Sanders, E.A.M., Hoes, A.W., Loon, A.M. van & Hak, E. (2008). Erratum: Influenza-
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167 Jansen, A.G.S.C., Sanders, E.A.M., Ende, A. van der, Loon, A.M. van, Hoes, A.W. & Hak, E. (2008).
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168 Jansen, A.G.S.C., Sanders, E.A.M., Wallinga, J., Groen, E.J., Loon, A.M. van, Hoes, A.W. & Hak, E. (2008). Rate-difference method proved satisfactory in estimating the influenza burden in primary
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169 Jansen, F.E., Vincken, K.L., Algra, A., Anbeek, P., Braams, O.B., Nellist, M, Zonnenberg, B.A.,
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170 Jansen, F.E., Braams, O.B., Vincken, K.L., Algra, A., Anbeek, P., Jennekens-Schinkel, A., Halley, D.,
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171 Janssen, K.J.M., Kalkman, C.J., Grobbee, D.E., Bonsel, G.J., Moons, K.G.M. & Vergouwe, Y. (2008).
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172 Janssen, K.J.M., Moons, K.G.M., Kalkman, C.J., Grobbee, D.E. & Vergouwe, Y. (2008). Updating
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173 Janssen, M.P., Over, J., Poel, C.L. van der, Cuijpers, H.T.M. & Hout, B.A. van (2008). A probabilistic
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174 Janssen, M.P., Borst, G.J. de, Mali, W.P.T.M., Kappelle, L.J., Moll, F.L., Ackerstaff, R.G., Rothwell, P.M.,
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175 Janssen, N.A.H., Meliefste, K., Fuchs, O., Weiland, S.K., Cassee, F.R., Brunekreef, B. & Sandstrom, T.
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176 Janssen, P.G.H., Gorter, K.J., Stolk, R.P. & Rutten, G.E.H.M. (2008). Do characteristics of practices
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177 Janssen, P.G.H., Gorter, K.J., Stolk, R.P., Akarsubasi, M. & Rutten, G.E.H.M. (2008). Three years
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178 Jenab, M., McKay, J.D., Ferrari, P., Biessy, C., Laing, S., Munar, G.M., Sala, N., Pena, S., Crusius, J.B.A.,
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179 Jonge, E de, Peelen, L.M., Keijzers, P.J., Joore, H., Lange, D. de, Voort, P.H., Bosman, R.J., Waal, R.A.,
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180 Jongh, M.A.C. de, Meeuwis, J.D., Baar, M.E. van, Stel, H.F. van, Schrijvers. A.J.P. (2008). Evaluation
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181 Joosten, E.A.G., Weert, G.H. de, Sensky, T., Staak, C.P.F. van der & Jong, C.A.J. de (2008). Effect of
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182 Joosten, E.A.G., DeFuentes-Merillas, L., Weert, G.H. de, Sensky, T., Staak, C.P.F. van der & Jong, C.A.J.
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183 Kahn, R.S., Fleischhacker, WW, Boter, H., Davidson, M., Vergouwe, Y., Keet, I.P.M., Gheorghe, M.D.,
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184 Kamphuis, M.H., Geerlings, M.I., Grobbee, D.E. & Kromhout, D. (2008). Dietary intake of B(6-9-12)
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185 Kars, M.C., Duijnstee, M.S.H., Pool, A., Delden, J.J.M. van & Grypdonck, M.H.F. (2008). Being there:
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186 Kastelein, J.J., Akdim, F., Stroes, E.S.G., Zwinderman, A.H., Bots, M.L., Stalenhoef, A.F., Visseren,
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187 Khan, A.E., Gallo, V., Linseisen, J., Kaaks, R., Rohrmann, S., Raaschou-Nielsen, O., Tjonneland, A.,
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188 King, M., Walker, C., Levy, G., Bottomley, C., Royston, P., Weich, S., Bellon-Saameno, J.A., Moreno, B.,
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189 King, M., Nazareth, I., Levy, G., Walker, C., Morris, R., Weich, S., Bello-Saameno, J.A., Moreno, B.,
Svab, I., Rotar, D., Rifel, J., Maaroos, H., Aluoja, A., Kalda, R., Neeleman, J., Geerlings, M.I., Xavier,
M., Almeida, M.C. de, Correa, B. & Torres-Gonzalez, F. (2008). Prevalence of common mental
disorders in general practice attendees across Europe. British Journal of Psychiatry, 192(5), 362-367.
190 Klungel, O.H., Storimans, M.J., Floor-Schreudering, A., Talsma, H., Rutten, G.E.H.M. & Blaey, C.J. de
(2008). Perceived diabetes status is independently associated with glucose monitoring behaviour
among type 2 diabetes mellitus patients. Primary Care Diabetes, 2, 25-30.
191 Knauff, A.H., Westerveld, H.E., Goverde, A.J., Eijkemans, M.J., Valkenburg, O., Santbrink, E.J. van,
Fauser, B.C.J.M. & Schouw, Y.T. van der (2008). Lipid profile of women with premature ovarian
failure. Menopause, 15(5), 919-923.
192 Kneyber, M.C.J., Woensel, J.B.M. van, Uijtendaal, E.V., Uiterwaal, C.S.P.M. & Kimpen, J.L.L. (2008).
Azithromycin does not improve disease course in hospitalized infants with respiratory syncytial virus
(RSV) lower respiratory tract disease: A randomized equivalence trial. Pediatric pulmonology,
43((2)), 142-149.
198 Annual Report 2008
193 Knol, M.J., Derijks, H.J., Geerlings, M.I., Heerdink, E.R., Souverein, P.C., Gorter, K.J., Grobbee, D.E. & Egberts, A.C.G. (2008). Influence of antidepressants on glycaemic control in patients with diabetes
mellitus. Pharmacoepidemiology and Drug Safety, 17(6), 577-586.
194 Knol, M.J., VandenBroucke, J.P., Scott, P. & Egger, M. (2008). What Do Case-Control Studies
Estimate? Survey of Methods and Assumptions in Published Case-Control Research. American
Journal of Epidemiology, 168(9), 1073-1081.
195 Koekkoek, B., Meijel, B.K.G. van, Schene, A. & Hutschemaekers, G. (2008). Clinical problems in the
long-term care of patients with chronic depression. Journal of Advanced Nursing, 62(6), 89-97.
196 Koffijberg, H., Buskens, E., Algra, A., Wermer, M.J.H. & Rinkel, G.J.E. (2008). Growth rates of
intracranial aneurysms: exploring constancy. Journal of Neurosurgery, 109(2), 176-185.
197 Koffijberg, H., Buskens, E., Granath, F., Adami, J., Ekbom, A., Rinkel, G.J.E. & Blomqvist, P. (2008).
Subarachnoid haemorrhage in Sweden 1987-2002: regional incidence and case fatality rates. Journal
of Neurology, Neurosurgery and Psychiatry, 79(3), 294-299.
198 Kooij, B.J.M. van, Handel, M. van, Uiterwaal, C.S.P.M., Groenendaal, F., Nievelstein, R.A.J.,
Rademaker, K.J., Jongmans, M.J. & Vries, L.S. de (2008). Corpus Callosum Size in Relation to Motor
Performance in 9- to 10-Year-Old Children with Neonatal Encephalopathy. Pediatric Research, 63(1),
103-108.
199 Koopman, L., Heijden, G.J.M.G. van der, Glasziou, P.P., Grobbee, D.E. & Rovers, M.M. (2008). A
systematic review of analytical methods used to study subgroups in (individual patient data) meta
analyses. Journal of Clinical Epidemiology, 60(10), 1002-1009.
200 Koopman, L., Hoes, A.W., Glasziou, P.P., Appelman, C.L.M., Burke, P., McCormick, D.P.,
Damoiseaux, R.A.M.J., Saux, N. Le & Rovers, M.M. (2008). Antibiotic therapy to prevent the
development of asymptomatic middle ear effusion in children with acute otitis media: a meta-analysis
of individual patient data. Archives of Otolaryngology - Head & Neck Surgery, 134(2), 128-132.
201 Koopman, L., Heijden, G.J.M.G. van der, Grobbee, D.E. & Rovers, M.M. (2008). Comparison of
methods of handling missing data in individual patient data meta-analyses: an empirical example on
antibiotics in children with acute otitis media. American Journal of Epidemiology, 167(5), 540-545.
202 Koopman, L., Heijden, G.J.M.G. van der, Hoes, A.W., Grobbee, D.E. & Rovers, M.M. (2008).
Empirical comparison of subgroup effects in conventional and individual patient data meta-analyses.
International Journal of Technology Assessment in Health Care, 24(3), 358-361.
203 Korstjens, I., May-de Groot, A.M., Weert, E. van, Mesters, I., Tan, F., Ros, W.J.G., Hoekstra-Weebers,
J.E., Schans, C.P. van der & Borne, B. van den (2008). Quality of life after self-management cancer
rehabilitation: a randomized controlled trial comparing physical and cognitive-behavioral training
versus physical training. Psychosomatic Medicine, 70(4), 422-429.
204 Kretzschmar, M.E.E. & Mikolajczyk, R (2008). Collecting social contact data in the context of
diasease transmission: prospective study designs. Social Networks, 30, 127-135.
205 Kretzschmar, M.E.E. & Wiessing, L.G. (2008). New challenges for mathematical and statistical
modeling of HIV and hepatitis C virus in injecting drug users. AIDS, 22(13), 1527-1537.
206 Kretzschmar, M.E.E., Zhang, W., Mikolajczyk, R.T., Wang, L., Sun, X., Kramer, A. & Lv, F (2008).
Regional differences in HIV prevalence among drug users in China: potential for future spread of
HIV? BMC Infectious Diseases, 4(8), 108.
207 Kretzschmar, M.E.E. & Wit, G.A. de (2008). Universal hepatitis B vaccination. The Lancet Infectious
Diseases, 8(2), 85-87.
208 Kretzschmar, M.E.E. (2008). Infectious Disease Modeling. In International Encyclopedia of Public
Health, Kris Heggenhougen and Stella Quah. San Diego: Academic Press.
209 Kretzschmar, M.E.E. (2008). Infectious Disease Modeling. In Kris Heggenhougen and Quah, editors
International Encyclopedia of Public Health. San Diego: Academic Press.
Publications 199
210 Kruyt, N.D., Roos, Y.W., Dorhout Mees, S.M., Berg, W.M. van den, Algra, A., Rinkel, G.J.E. & Biessels,
G.J. (2008). High mean fasting glucose levels independently predict poor outcome and delayed
cerebral ischemia after aneurysmal subarachnoid haemorrhage. Journal of Neurology, Neurosurgery
and Psychiatry, 79, 1382-1385.
211 Laar, P.J. van, Graaf, Y. van der, Mali, W.P.T.M., Grond, J. van der, Hendrikse, J. & SMART, Study
(2008). Effect of cerebrovascular risk factors on regional cerebral blood flow. Radiology, 246(1), 198-
204.
212 Laar, P.J. van, Raamt, A.F. van, Grond, J. van der, Mali, W.P.T.M., Graaf, Y. van der, Hendrikse, J. &
SMART, Study (2008). Increasing levels of TNFalpha are associated with increased brain perfusion.
Atherosclerosis, 196(1), 449-454.
213 Lambers Heerspink, H.J., Dobre, D., Hillege, H.L., Grobbee, D.E. & Zeeuw, D. de (2008). Does the
European clinical trials directive really improve clinical trial approval time? British Journal of Clinical
Pharmacology, 66(4), 546-550.
214 Lambers Heerspink, H.J., Knol, M.J., Tijssen, R.J., van Leeuwen, T.N., Grobbee, D.E. & Zeeuw, D. de
(2008). Is the randomized controlled drug trial in Europe lagging behind the USA? British Journal of
Clinical Pharmacology, 66(6), 774-780.
215 Leeflang, M.M., Moons, K.G.M., Reitsma, J.B. & Zwinderman, A.H. (2008). Bias in sensitivity and
specificity caused by data-driven selection of optimal cutoff values: mechanisms, magnitude, and
solutions. Clinical chemistry, 54((4)), 729-737.
216 Leendertse, M., Willems, R.J.L., Giebelen, A.J., Pangaart, P.S. van den, Wiersinga, W.J., Vos, A.F. de,
Florquin, S., Bonten, M.J.M. & Poll, T. van der (2008). TLR2-dependent MyD88 signaling contributes
to early host defense in murine Enterococcus faecium peritonitis. Journal of Immunology, 180(7),
4865-4874.
217 Leeuw, J.R.J. de, Vliet, M.J. van & Ausems, M.G.E.M. (2008). Predictors of choosing life-long
screening or prophylactic surgery in women at high and moderate risk for breast and ovarian cancer.
Familial Cancer, 7(4), 347-359.
218 Lemmens, L.C., Kerkkamp, H.E.M., Klei, W.A. van, Klazinga, N.S., Rutten, C.L.G., Linge, R.H. van &
Moons, K.G.M. (2008). Facilitating and limiting factors for implmentation of outpatient preoperative
evaluation clinics. British Journal of Anaesthesia, 100, 645-651.
219 Lemmens, L.C., Kerkkamp, H.E.M., Klei, W.A. van, Klazinga, N.S., Rutten, C.L., Linge, R.H. van &
Moons, K.G.M. (2008). Implementation of outpatient preoperative evaluation clinics: facilitating and
limiting factors. British Journal of Anaesthesia, 100(5), 645-651.
220 Lips, I.M., Dehnad, H., Gils, C.H. van, Boeken Kruger, A.E., Heide, U.A. van der & Vulpen, M. van
(2008). High-dose intensity-modulated radiotherapy for prostate cancer using daily fiducial marker-
based position verification: acute and late toxicity in 331 patients. Radiation Oncology [E], 21(3), 15.
221 Lübbeke, A., Moons, K.G.M., Garavaglia, G. & Hoffmeyer, P. (2008). Outcomes of obese and
nonobese patients undergoing revision total hip arthroplasty. Arthritis and Rheumatism, 59(5), 738-
745.
222 Lumbreras, B., Garte, S., Overvad, K., Tjonneland, A., Clavel-Chapelon, F., Linseisen, J., Boeing, H.,
Trichopoulou, A., Palli, D., Peluso, M., Krogh, V., Tumino, R., Panico, S., Bueno-de-Mesquita, H.B.,
Peeters, P.H.M., Lund, E., Martinez, C., Dorronsoro, M., Barricarte, A., Chirlaque, M.D., Quiros, J.R.,
Berglund, G., Hallmans, G., Day, N.E., Key, T.J., Saracci, R., Kaaks, R., Malaveille, C., Ferrari, P.,
Boffetta, P., Norat, T., Riboli, E., Gonzalez, C.A. & Vineis, P. (2008). Meat intake and bladder cancer in
a prospective study: a role for heterocyclic aromatic amines? Cancer Causes & Control, 19(6), 649-
656.
223 Lutgens, M.W.M.D., Meijer, M, Peeters, B.P., Poulsen, M.L., Rutten, M.J., Bots, M.L., Heijden, G.J.M.G. van der & Soedamah-Muthu, S.S (2008). Easily obtainable clinical features increase the
diagnostic accuracy for latent autoimmune diabetes in adults: an evidence-based report. Primary Care
Diabetes, 2(4), 207-211.
200 Annual Report 2008
224 Manschot, S.M., Biessels, G.J., Rutten, G.E.H.M., Kessels, R.C., Gispen, W.H. & Kappelle, L.J. (2008).
Peripheral and central neurologic complications in type 2 diabetes mellitus: No association in
individual patients. Journal of the Neurological Sciences, 264(1-2), 157-162.
225 Marschall, T, Kretzschmar, M.E.E., Mangen, M.J.J. & Schalm, S. (2008). High impact of migration on
the prevalence of chronic hepatitis B in the Netherlands. European Journal of Gastroenterology and
Hepatology, 20(12), 1214-1225.
226 Martens, F.M.A.C., Graaf, Y. van der, Dijk, J.M., Olijhoek, J.K. & Visseren, F.L.J. (2008). Carotid
arterial stiffness is marginally higher in the metabolic syndrome and markedly higher in type 2
diabetes mellitus in patients with manifestations of arterial disease. Atherosclerosis, 197(2), 646-653.
227 May, A.M., Weert, E. van, Korstjens, I., Hoekstra-Weebers, J.E., Schans, C.P. van der, Zonderland, M.L.,
Mesters, I., Borne, B.V. & Ros, W.J.G. (2008). Improved physical fitness of cancer survivors: a
randomised controlled trial comparing physical training with physical and cognitive-behavioural
training. Acta Oncologica, 47(5), 1825-1834.
228 May-de Groot, A.M., Duivenvoorden, H.J., Korstjens, I., Weert, E. van, Hoekstra-Weebers, J.E., Borne,
B. van den, Mesters, I., Schans, C.P. van der & Ros, W.J.G. (2008). The effect of group cohesion on
rehabilitation outcome in cancer survivors. Psycho-oncology, 17(9), 917-925.
229 McKay, J.D., Hung, R.J., Gaborieau, V., Boffetta, P., Chabrier, A., Byrnes, G.B., Zaridze, D., Mukeria, A.,
Szeszenia-Dabrowska, N., Lissowska, J, Rudnai, P., Fabianova, E., Mates, D., Bencko, V., Foretova, L.,
Janout, V., McLaughlin, J., Shepherd, F., Montpetit, A., Narod, S., Krokan, H.E., Skorpen, F., Elvestadt,
M.B., Vatten, L., Njolstad, I., Axelsson, T., Chen, C., Goodman, G., Barnett, M., Loomis, M.M.,
Lubinski, J., Matyjasik, J., Lener, M., Oszutowska, D., Field, J., Liloglou, T., Xinarianos, G., Cassidy, A.,
Vineis, P., Clavel-Chapelon, F., Palli, D., Tumino, R., Krogh, V., Panico, S., Gonzalez, C.A., Ramon
Quiros, J., Martinez, C., Navarro, C., Ardanaz, E., Larranaga, N., Kham, K.T., Key, T.J., Bueno-de-
Mesquita, H.B., Peeters, P.H.M., Trichopoulou, A., Linseisen, J., Boeing, H., Hallmans, G., Overvad,
K., Tjonneland, A., Kumle, M., Riboli, E., Zelenika, D., Boland, A., Delepine, M., Foglio, M., Lechner,
D., Matsuda, F., Blanche, H., Gut, I., Health, S., Lathrop, M. & Brennan, P. (2008). Lung cancer
susceptibility locus at 5p15.33. Nature Genetics, 40(12), 1404-1406.
230 Meijer-Hoogeveen, M., Holsbeke, C. van, Tweel, I. van der, Stoutenbeek, Ph. & Visser, G.H.A. (2008).
Sonographic longitudinal cervical length measurements in nulliparous women at term: prediction of
spontaneous onset of labor. Ultrasound in Obstetrics and Gynecology, 32(5), 652-656.
231 Metz, R., Verleisdonk, E.J.M.M., Heijden, G.J.M.G. van der, Clevers, G.J., Hammacher, E.R.,
Verhofstad, M.H.J. & Werken, Chr. van der (2008). Acute Achilles Tendon Rupture: Minimally
Invasive Surgery Versus Nonoperative Treatment With Immediate Full Weightbearing--A
Randomized Controlled Trial. American Journal of Sports Medicine, 36(9), 1688-1694.
232 Mikolajczyk, R, Akmatov, M, Rastin, S & Kretzschmar, M.E.E. (2008). Social contacts of school
children and the transmission of respiratory-spread pathogens. Epidemiology and Infection, 136(6),
813-822.
233 Mikolajczyk, R.T., Akmatov, M.K., Stich, H., Kramer, A. & Kretzschmar, M.E.E. (2008). Association
between acculturation and childhood vaccination coverage in migrant populations: a population
based study from a rural region in Bavaria, Germany. International Journal of Public Health, 53(4),
180-187.
234 Molenaar, E.A., Hwang, S.J., Vasan, R.S., Grobbee, D.E., Meigs, J.B., D’Agostino, R.B. Sr, Levy, D. &
Fox, C.S. (2008). Burden and rates of treatment and control of cardiovascular disease risk factors in
obesity: the Framingham Heart Study. Diabetes Care, 31(7), 1367-1372.
235 Monforte, A., Abrams, D., Schneider, M.M.E., Bonten, M.J.M., Borleffs, J.C.C., Ellerbroek, P.M.,
Jaspers, C.A.J.J., Schurink, C.A.M., Hoepelman, I.M. & D.A.D., Study Group (2008). HIV-induced
immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies. AIDS,
22(16), 2143-2153.
Publications 201
236 Mugavero, M.J., May, M., Harris, R., Saag, M.S., Costaliola, D., Egger, M., Phillips, A., Gunthard, H.F.,
Dabis, F., Hogg, R., Wolf, F. de, Fatkenheuer, G., Gill, M.J., Justice, A., D’Armino Montforte, A., Lampe,
F., Miro, J.M., Staszewski, S., Sterne, J.A., Boucher, C.A.B., Bonten, M.J.M., Hoepelman, I.M.,
Schneider, M.M.E., Borleffs, J.C.C., Ellerbroek, P.M., Jaspers, C.A.J.J., Mudrikova, T., Schurink, C.A.M.,
Gisolf, E.H., Geelen, S.P.M., Wolfs, T.F.W., Faber, T.E. & Antiretroviral Therapy Cohort Collaboration,
ART-CC (2008). Does short-term virologic failure translate to clinical events in antiretroviral-naïve
patients initiating antiretroviral therapy in clinical practice? AIDS, 22(18), 2481-2492.
237 Muller, L.M.A.J., Gorter, K.J., Rutten, G.E.H.M., Hoepelman, I.M. & Hak, E. (2008). A clinical
prediction rule for urinary tract infections in patients with type 2 diabetes mellitus in primary care.
Epidemiology and Infection, 137(2), 166-172.
238 Muller, L.M.A.J., Gorter, K.J., Hak, E. & Rutten, G.E.H.M. (2008). Short-term effects of an
educational program on health-seeking behavior for infections in patients with type 2 diabetes: a
randomized controlled intervention trial in primary care. Diabetes Care, 31(3), 402-407.
239 Mylius, S.D., Hagenaars, T.J., Lugner, A.K. & Wallinga, J. (2008). Optimal allocation of pandemic
influenza vaccine depends on age, risk and timing. Vaccine, 26, 3742-3749.
240 Nicholson, A, Berger, K., Bohn, R., Carcao, M., Fischer, K., Gringeri, A., Hoots, K., Mantovani, L.,
Schramm, W., Hout, B.A. van, Willan, A.R. & Feldman, B.M. (2008). Recommendations for reporting
economic evaluations of haemophilia prophylaxis: a nominal groups consensus statement on behalf
of the Economics Expert Working Group of The International Prophylaxis Study Group.
Haemophilia, 14(1), 127-132.
241 Nieboer, P., Vries, E.G.E. de, Mulder, N.H., Rodenhuis, S., Bontenbal, M., Wall, E. van der, Hoesel,
Q.G.C.M. Van, Smit, W.M., Hupperets, P., Voest, E.E., Nooij, M.A., Boezen, H.M. & Graaf, W.T.A. van
der (2008). Factors influencing catheter-related infections in the Dutch multicenter study on highdose
chemotherapy followed by peripheral SCT in high-risk breast cancer patients. Bone Marrow
Transplantation, 42, 475-481.
242 Nierich, A.P., Zaane, B. van, Buhre, W.F., Coddens, J., Spanjersberg, A.J. & Moons, K.G.M. (2008).
Visualization of the distal ascending aorta with A-Mode transesophageal echocardiography. Journal
of Cardiothoracic Vascular Anesthesia, 22(5), 766-773.
243 Nieters, A., Rohrmann, S., Becker, N., Linseisen, J., Ruediger, T., Overvad, K., Tjonneland, A., Olsen,
A., Allen, N.E., Travis, R.C., Bingham, S, Khaw, K.T., Ardanaz, E., Redondo, M.L., Basterrechea, M,
Martinez, C., Tormo, M.J., Rosso, S., Tagliabue, G., Masala, G., Mattiello, A., Tumino, R., Boeing, H.,
Bergmann, M., Kaaks, R., Trichopoulou, A., Trichopoulos, D., Peeters, P.H.M., Bueno-de-Mesquita,
B., Boffetta, P., Brennan, P., Ferrari, P., Neasham, D., Lund, E., Berglund, G., Manjer, J., Hallmans, G.,
Johansson, I., Vineis, P. & Riboli, E. (2008). Smoking and lymphoma risk in the European prospective
investigation into cancer and nutrition. American Journal of Epidemiology, 167(9), 1081-1089.
244 Nijdam, M.E., Plantinga, Y., Hulsen, H.T., Bos, W.J., Grobbee, D.E., Schouw, Y.T. van der & Bots, M.L. (2008). Pulse pressure amplification and risk of cardiovascular disease. American Journal of
Hypertension, 21(4), 388-392.
245 Noss, I., Wouters, I.M., Visser, M., Heederik, D.J.J., Thorne, P.S., Brunekreef, B. & Doekes, G. (2008).
Evaluation of a low-cost electrostatic dust fall collector for indoor air endotoxin exposure assessment.
Applied and Environmental Microbiology, 74(18), 5621-5627.
246 Nothlings, U., Schulze, M.B., Weikert, C., Boeing, H., Schouw, Y.T. van der, Bamia, C., Benetou, V.,
Lagiou, P., Krogh, V., Beulens, J.W.J., Peeters, P.H.M., Halkjaer, J., Tjonneland, A., Tumino, R., Panico,
S., Masala, G., Clavel-Chapelon, F., Lauzon, B. de, Boutron-Ruault, M.C., Vercambre, M.N., Kaaks, R.,
Linseisen, J., Overvad, K., Arriola, L., Ardanaz, E., Gonzalez, C.A., Tormo, M.J., Bingham, S, Khaw,
K.T., Key, T.J., Vineis, P., Riboli, E., Ferrari, P., Boffetta, P., Bueno-de-Mesquita, H.B., A, D.L. van der,
Berglund, G., Wirfalt, E., Hallmans, G., Johansson, I., Lund, E. & Trichopoulo, A. (2008). Intake of
vegetables, legumes, and fruit, and risk for all-cause, cardiovascular, and cancer mortality in a
European diabetic population. Journal of Nutrition, 138(4), 775-781.
202 Annual Report 2008
247 Oftedal, B., Brunekreef, B., Nystad, W., Madsen, C., Walker, S.E. & Nafstad, P. (2008). Residential
outdoor air pollution and lung function in schoolchildren. Epidemiology, 19(1), 129-137.
248 Olijhoek, J.K., Hajer, G.R., Graaf, Y. van der, Dallinga-Thie, G.M. & Visseren, F.L.J. (2008). The effects
of low-dose simvastatin and ezetimibe compared to high-dose simvastatin alone on post-fat load
endothelial function in patients with metabolic syndrome: a randomized double-blind crossover trial.
Journal of Cardiovascular Pharmacology, 52(2), 145-150.
249 Ong, D.S., Kuyvenhoven, M.M., Dijk, L. van & Verheij, Th.J.M. (2008). Antibiotics for respiratory, ear
and urinary tract disorders and consistency among GPs. Journal of Antimicrobial Chemotherapy,
62(3), 587-592.
250 Opstelten, W., Essen, G.A. van & Hak, E. (2008). Determinants of non-compliance with herpes zoster
vaccination in the community-dwelling elderly. Vaccine, 27(2), 192-196.
251 Opstelten, W. & Zaal, M.J.W. (2008). Diagnostic tips for ophthalmic zoster. The Journal of Family
Practice, 57(2), 81.
252 Opstelten, W., Essen, G.A. van, Ballieux, M.J. & Goudswaard, A.N. (2008). Influenza immunization
of Dutch general practitioners: Vaccination rate and attitudes towards vaccination. Vaccine, 26(47),
5918-5921.
253 Opstelten, W., Eekhof, J.A.H., Neven, A.K. & Verheij, Th.J.M. (2008). Treatment of herpes zoster.
Canadian family physician, 54(3), 373-377.
254 Os-Medendorp, H. van, Guikers, C.L.H., Eland-de Kok, P.C.M., Ros, W.J.G., Bruijnzeel-Koomen,
C.A.F.M. & Buskens, E. (2008). Costs and cost-effectiveness of the nursing programme “Coping with
itch” for patients with chronic pruritic skin disease. British Journal of Dermatology, 158, 1013-1021.
255 Os-Medendorp, H. van, Eland-de Kok, P.C.M., Linge, R.H. van, Bruijnzeel-Koomen, C.A.F.M.,
Grypdonck, M.H.F. & Ros, W. (2008). The tailored implementation of the nursing programme
“coping with itch”. Journal of Clinical Nursing, 17(11), 1460-1470.
256 Otten, C.M, Kok, L., Witteman, B.J., Baumgarten, R., Kampman, E., Moons, K.G.M. & Wit, N.J. de
(2008). Diagnostic performance of rapid tests for detection of fecal calprotectin and lactoferrin and
their ability to discriminate inflammatory from irritable bowelsyndrome. Clinical Chemistry and
Laboratory Medicine, 46(9), 1275-1280.
257 Pagter, P.J. de, Schuurman, R., Visscher, H., Vos, M. de, Bierings, M.B., Loon, A.M. van, Uiterwaal, C.S.P.M., Baarle, D. van, Sanders, E.A.M. & Boelens, J.J. (2008). Human herpes virus 6 plasma DNA
positivity after hematopoietic stem cell transplantation in children: an important risk factor for
clinical outcome. Biology of blood and marrow transplantation, 14(7), 831-839.
258 Patel, A., Cheng, I., Canzian, F., LeMarchand, L., Thun, M.J., Berg, C.D., Buring, J.E., Calle, E.E.,
Chanock, S., Clavel-Chapelon, F., Cox, D.G., Dorronsoro, M., Dossus, L., Haiman, C.A., Hankinson,
S.E., Henderson, B.E., Hoover, R., Hunter, D.J., Kaaks, R., Kolonel, L.N., Kraft, P., Linseisen, J., Lund,
E., Manjer, J., McCarty, C., Peeters, P.H.M., Pike, M.C., Pollak, M., Riboli, E., Stram, D.O., Tjonneland,
A., Travis, R.C., Trichopoulos, D., Tumino, R., Yeager, M., Ziegler, R. & Feigelson, H.S. (2008). IGF-1,
IGFBP-1, and IGFBP-3 polymorphisms predict circulating IGF levels but not breast cancer risk:
findings from the Breast and Prostate Cancer Cohort Consortium (BPC3). PLoS ONE [E], 3(7), 2578.
259 Patel, A., MacMahon, S., Chalmers, J., Neal, B., Billot, L., Woodward, M., Marre, M., Cooper, M.,
Glasziou, P., Grobbee, D.E., Hamet, P., Harrap, S., Heller, S., Liu, L., Mancia, G., Mogensen, C.E., Pan,
C.Y., Poulter, N., Rodgers, A., Williams, B., Bompoint, S, Galan, B.E. de, Joshi, R. & Travert, F. (2008).
Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. New England
Journal of Medicine, 12;358(24), 2560-2572.
260 Patricio, M., Engelsen, C. den, Tseng, D. & Cate, Th.J. ten (2008). State of implementation of the two-
cycle BaMa system in medical education: were do we stand in 2007? Medical Teacher, 30(6), 597-605.
Publications 203
261 Peluso, M., Airoldi, L., Munnia, A., Colombi, A., Veglia, F., Autrup, H., Dunning, A., Garte, S.,
Gormally, E., Malaveille, C., Matullo, G., Overvad, K., Raaschou-Nielsen, O., Clavel-Chapelon, F.,
Linseisen, J., Boeing, H., Trichopoulou, A., Palli, D., Krogh, V., Tumino, R., Panico, S., Bueno-de-
Mesquita, B., Peeters, P.H.M., Kumle, M., Agudo, A, Martinez, C., Dorronsoro, M., Barricarte, A.,
Tormo, M.J., Quiros, J.R., Berglund, G., Jarvholm, B., Day, N.E., Key, T.J., Saracci, R., Kaaks, R., Riboli,
E., Bingham, S & Vineis, P. (2008). Bulky DNA adducts, 4-aminobiphenyl-haemoglobin adducts and
diet in the European Prospective Investigation into Cancer and Nutrition (EPIC) prospective study.
British Journal of Nutrition, 14, 1-7.
262 Peters, N.H., Bosch, M.A.A.J. van den, Peeters, P.H.M., Mali, W.P.T.M. & Borel Rinkes, I.H.M. (2008).
Breast magnetic resonance imaging in early-stage breast cancer: is there really no value? Journal of
Clinical Oncology, 26(20), 3465-3466.
263 Peters, N.H., Borel Rinkes, I.H.M., Zuithoff, N.P.A., Mali, W.P.T.M., Moons, K.G.M. & Peeters, P.H.
(2008). Meta-analysis of MR imaging in the diagnosis of breast lesions. Radiology, 246(1), 116-124.
264 Petrov, M.S., Santvoort, H.C. van, Besselink, M.G.H., Heijden, G.J.M.G. van der, Erpecum, K.J. van &
Gooszen, H.G. (2008). Early endoscopic retrograde cholangiopancreatography versus conservative
management in acute biliary pancreatitis without cholangitis: a meta-analysis of randomized trials.
Annals of Surgery, 247(2), 250-257.
265 Petrov, M.S., Santvoort, H.C. van, Besselink, M.G.H., Heijden, G.J.M.G. van der, Windsor, P.A. &
Gooszen, H.G. (2008). Enteral Nutrition and the Risk of Mortality and Infectious Complications in
Patients With Severe Acute Pancreatitis. Archives of Surgery, 143(11), 1111-1117.
266 Pfefferle, P.I., Sel, S., Johannes, E.M., Buchele, G., Blumer, N., Krauss-Etschmann, S., Herzum, I.,
Albers, C.E., Lauener, R.P., Roponen, M., Hirvonen, M.R., Vuitton, D.A., Riedler, J., Brunekreef, B., Dalphin, J.C., Braun-Fahrlander, C., Pekkanen, J., von Mutius, E. & Renz, H. (2008). Cord blood
allergen-specific IgE is associated with reduced IFN-gamma production by cord blood cells: The
Protection against Allergy-Study in Rural Environments (PASTURE) study. Journal of Allergy and
Clinical Immunology, 122(4), 711-716.
267 Pischon, T., Boeing, H., Hoffmann, K., Bergmann, M., Schulze, M.B., Overvad, K., Schouw, Y.T. van der, Spencer, E., Moons, K.G.M., Tjonneland, A., Halkjaer, J., Jensen, M.K., Stegger, J., Clavel-
Chapelon, F., Boutron-Ruault, M.C., Chajes, V., Linseisen, J., Kaaks, R., Trichopoulou, A.,
Trichopoulos, D., Bamia, C., Sieri, S., Palli, D., Tumino, R., Vineis, P., Panico, S., Peeters, P.H.M., May, A.M., Bueno-de-Mesquita, H.B., Duijnhoven, F.J.B van, Hallmans, G., Weinehall, L., Manjes, J.,
Hedblad, B., Lund, E., Agudo, A, Arriola, L., Barricarte, A., Navarro, C., Martinez, C., Quiros, J.R., Key,
T.J., Bingham, S, Khaw, K.T., Boffetta, P., Jenab, M., Ferrari, P. & Riboli, E. (2008). General and
abdominal adiposity and risk of death in Europe. New England Journal of Medicine, 359(20), 2105-
2120.
268 Plug, I., Peters, M., Mauser-Bunschoten, E.P., Goede-Bolder, A. de, Heijen, L., Smit, C., Willemse, J.,
Rosendaal, F.R. & Bom, J.G. van der (2008). Social participation of patients with hemophilia in the
Netherlands. Blood, 111(4), 1811-1815.
269 Posthouwer, D., Mauser-Bunschoten, E.P. & Fischer, K. (2008). Liver biopsy in patients with
haemophilia; in search for a reliable, non-invasive alternative. Haemophilia, 14, 647-648.
270 Pruissen, D.M.O., Slooter, A.J.C., Rosendaal, F.R., Graaf, Y. van der & Algra, A. (2008). Coagulation
factor XIII gene variation, oral contraceptives and risk of ischemic stroke. Blood, 111(3), 1282-1286.
271 Pruissen, D.M.O., Rosendaal, F.R., Frijns, C.J.M., Kappelle, L.J., Vos, H.L. & Algra, A. (2008).
Prothrombotic gene variation and new vascular events after cerebral ischemia of arterial origin.
Journal of Thrombosis and Haemostasis, 6(10), 1639-1644.
272 Pruissen, D.M.O., Kappelle, L.J., Rosendaal, F.R., Moll, F.L., Algra, A. & SMART, Study (2008).
Prothrombotic gene variation in patients with large and small vessel disease. Neuroepidemiology,
31(2), 89-92.
204 Annual Report 2008
273 Putte, E.M. van de, Böcker, K.B.E., Buitelaar, J., Kenemans, J.L., Engelbert, R.H.H., Kuis, W., Kimpen,
J.L.L. & Uiterwaal, C.S.P.M. (2008). Deficits of interference control in adolescents with chronic
fatigue syndrome. Archives of pediatrics & adolescent medicine, 162(12), 1196-1197.
274 Quanjer, P.H., Borsboom, G.J.J.M., Kivastik, J., Merkus, P.J.F.M., Hankinson, J.L., Houthuijs, D.,
Brunekreef, B., Ihorst, G. & Kühr, J. (2008). Cross-sectional and Longitudinal Spirometry in Children
and Adolescents: Interpretative Strategies. American Journal of Respiratory and Critical Care
Medicine, 178(12), 1262-1270.
275 Raaijmakers, M.A.J., Koffijberg, H., Posthumus, J.A., Hout, B.A. van, Engeland, H. van & Matthys,
W.C.H.J. (2008). Assessing performance of a randomized versus a non-randomized study design.
Contemporary Clinical Trials, 29(2), 293-303.
276 Rademaker, K.J., Vries, L.S. de, Uiterwaal, C.S.P.M., Groenendaal, F., Grobbee, D.E. & Bel, F. van
(2008). Postnatal hydrocortisone treatment for chronic lung disease in the preterm newborn and
long-term neurodevelopmental follow-up. Archives of Disease in Childhood Fetal and Neonatal
Edition, 93(1), 58-63.
277 Regieli, J.J., Jukema, J.W., Grobbee, D.E., Kastelein, J.J.P., Kuivenhoven, J.A., Zwinderman, A.H., Graaf, Y. van der, Bots, M.L. & Doevendans, P.A.F.M. (2008). CETP genotype predicts increased mortality in
statin-treated men with proven cardiovascular disease: An adverse pharmacogenetic interaction.
European Heart Journal, 29(22), 2792-2799.
278 Regt, M.J.A. de, Wagen, L.E. van der, Top, J., Blok, H.E.M., Hopmans, T.E.M., Dekker, A.W., Hene, R.J.,
Siersema, P.D., Willems, R.J.L. & Bonten, M.J.M. (2008). High acquisition and environmental
contramination rates of CC17 ampicillin-resistant Enterococcus faecium in a Dutch hospital. Journal
of Antimicrobial Chemotherapy, 62(6), 1401-1406.
279 Rietjens, J.A.C., Delden, J.J.M. van, Onwuteaka-Philipsen, B.D., Buiting, H.M., Maas, P.J. van der &
Heide, A. van der (2008). Continuous deep sedation for patients nearing death in the Netherlands:
descriptive study. British Medical Journal, 336(7648), 810-813.
280 Rijen, MML van, Bonten, M.J.M., Wenzel, R.P. & Kluytmans, J.A.J.W. (2008). Intranasal mupirocin
for reduction of Staphylococcus aureus infections in surgical patients with nasal carriage: a systematic
review. Journal of Antimicrobial Chemotherapy, 61(2), 254-261.
281 Rijen, MML van, Bonten, M.J.M., Wenzel, R.P. & Kluytmans, J.A.J.W. (2008). Mupirocin ointment for
preventing Staphylococcus aureus infections in nasal carriers. The Cochrane Database of Systematic
Reviews [E], 4, CD006216.
282 Rijn, M. van, Jansma, J., Brinksma, A., Bakker, H.D., Boers, G.H.J., Carbasius Weber, E.C., Douwes,
A.C., Herberg, A. van den, Horst, N.M. ter, Klerk, J.B.C. de, Koning, T.J. de, Ploeg, L. van den, Rubio-
Gozalbo, M.E., Sels, J.P., Sengers, R.C.A., Valk, H.W. de, Termeulen, H., Zweers, H. & Spronsen, F.J.
van (2008). A survey of natural protein intake in Dutch phenylketonuria patients: insight into
estimation or measurement of dietary intake. Journal of the American Dietetic Association, 108(10),
1704-1707.
283 Rinaldi, S., Rohrmann, S., Jenab, M., Biessy, C., Sieri, S., Palli, D., Tumino, R., Mattiello, A., Vineis, P.,
Nieters, A., Linseisen, J., Pischon, T., Boeing, H., Hallmans, G., Palmqvist, R., Manjer, J., Wirfalt, E.,
Crowe, F., Khaw, K.T., Bingham, S, Tjonneland, A., Olsen, A., Overvad, K., Lund, E., Skeie, G., Clavel-
Chapelon, F., Boutron-Ruault, M.C., Lauzon-Guillain, B., Ardanaz, E., Jakszyn, P., Quiros, J.R.,
Chirlaque, M.D., Sanchez, M.J., Dorronsoro, M., Trichopoulou, A., Lagiou, P., Trichopoulos, D.,
Bueno-de-Mesquita, H.B., Duijnhoven, F.J.B van, Peeters, P.H.M., Slimani, N., Ferrari, P., Byrnes, G.B., Riboli, E. & Kaaks, R. (2008). Glycosylated hemoglobin and risk
of colorectal cancer in men and women, the European prospective investigation into cancer and
nutrition. Cancer Epidemiology Biomarkers & Prevention, 17(11), 3108-3115.
284 Rodriguez, J.A., Hellings, W.E., Moll, F.L., Vries, J.P.P.M. de, Middelaar, B.J. van, Algra, A., Sluijter,
J.P.G., Velema, E., Broek, T. van den, Sessa, W.C., Kleijn, D.P.V. de & Pasterkamp, G. (2008). Caveolin-1
influences vascular protease activity and is a potential stabilizing factor in human atherosclerotic
disease. PLoS ONE [E], 3(7), e2612/1-e2612/12.
Publications 205
285 Roos, K., Meijs, M.F.L., Vos, A.M. de, Rutten, A., Doevendans, P.A.F.M., Schouw, Y.T. van der, Prokop,
W.M., Bots, M.L. & Vonken, E.P.A. (2008). Myocardial adipose tissue in healthy postmenopausal
women: no relations with vascular risk. European Journal of Clinical Investigation, 38(10), 786-787.
286 Roukema, J., Loenhout, R.B. van, Steyerberg, E.W., Moons, K.G.M., Bleeker, S.E. & Moll, H.A. (2008).
Polytomous regression did not outperform dichotomous logistic regression in diagnosing serious
bacterial infections in febrile children. Journal of Clinical Epidemiology, 61(2), 135-141.
287 Rovers, M.M., Numans, M.E., Langenbach, E., Grobbee, D.E., Verheij, Th.J.M. & Schilder, A.G.M.
(2008). Is pacifier use a risk factor for acute otitis media? A dynamic cohort study. Family Practice,
25(4), 233-236.
288 Ruskamp, J.M., Hoekstra, M.O., Postma, D.S., Kerkhof, M., Bottema, R.W.B., Koppelman, G.H.,
Rovers, M.M., Wijga, A.H., Jongste, J.C. de, Brunekreef, B. & Sanders, E.A.M. (2008). Exploring the
role of polymorphisms in ficolin genes in respiratory tract infections in children. Clinical and
Experimental Immunology, 155, 433-440.
289 Ruskamp, J.M., Hoekstra, M.O., Postma, D.S., Kerkhof, M., Bottema, R.W.B., Koppelman, G.H.,
Rovers, M.M., Wijga, A.H., Jongste, J.C. de, Brunekreef, B. & Sanders, E.A.M. (2008). Polymorphisms
in the mannan-binding lectin gene are not associated with questionnaire-reported respiratory tract
infections in children. Journal of Infectious Diseases, 198(11), 1707--13.
290 Rutten, F.H. & Hoes, A.W. (2008). B-type natriuretic peptide assays for detecting heart failure in the
elderly: same value as those in the younger? International Journal of Cardiology, 125(2), 161-165.
291 Rutten, F.H., Vonken, E.P.A., Cramer, M.J.M., Moons, K.G.M., Velthuis, B., Prakken, N.H.J., Lammers,
J.W.J., Grobbee, D.E., Mali, W.P.T.M. & Hoes, A.W. (2008). Cardiovascular magnetic resonance
imaging to identify left-sided chronic heart failure in stable patients with chronic obstructive
pulmonary disease. American Heart Journal, 156(3), 506-512.
292 Sabour, S., Atsma, F., Rutten, A., Grobbee, D.E., Mali, W.P.T.M., Prokop, W.M. & Bots, M.L. (2008).
Multi Detector-Row Computed Tomography (MDCT) had excellent reproducibility of coronary
calcium measurements. Journal of Clinical Epidemiology, 61(6), 572-579.
293 Scheffer, A., Rooij, S.E., Hooft, T. van ‘t & Schuurmans, M.J. (2008). Fear of falling: measurement
strategy, prevalence, risk factors and consequences among older persons: a systematic review.r. Age
and Ageing, 37(1), 19-24.
294 Scheltens, T., Verschuren, W.M., Boshuizen, H.C., Hoes, A.W., Zuithoff, N.P.A., Bots, M.L. &
Grobbee, D.E. (2008). Estimation of cardiovascular risk: a comparison between the Framingham and
the SCORE model in people under 60 years of age. European Journal of Cardiovascular Prevention
and Rehabilitation, 15(5), 562-566.
295 Schlösser, F.J.V., Tangelder, M.J., Verhagen, H.J., Heijden, G.J.M.G. van der, Muhs, B.E., Graaf, Y. van der, Moll, F.L. & SMART, Study Group (2008). Growth predictors and prognosis of small abdominal
aortic aneurysms [Smart Study Group]. Journal of Vascular Surgery, 47, 1127-1133.
296 Schlösser, F.J.V., Heijden, G.J.M.G. van der, Graaf, Y. van der, Moll, F.L. & Verhagen, H.J.M. (2008).
Predictors of adverse events after endovascular abdominal aortic aneurysm repair. A meta-analysis of
case reports. Journal of Medical Case Reports [E], 2(1), 303-303.
297 Scholtens, S., Brunekreef, B., Smit, H.A., Gast, G.C.M., Hoekstra, M.O., Jongste, J.C. de, Postma, D.S.,
Gerritsen, J., Seidell, J.C. & Wijga, A.H. (2008). Do differences in childhood diet explain the reduced
overweight risk in breastfed children? Obesity (Silver Spring), 16(11), 2498-2503.
298 Schreinemakers, J.M.J., Elias, S.G. & Borel Rinkes, I.H.M. (2008). Retroperitoneal endoscopic versus
conventional open adrenalectomy: a cost-effectiveness analysis. Journal of Laparoendoscopic Surgery
& Advanced Surgical Techniques. Part A., 18(5), 707-712.
299 Schryver, E.L.L.M. de, Algra, A. & Gijn, J. van (2008). Dipyridamole for preventing stroke and other
vascular events in patients with vascular disease: an update. Stroke, 39(4), 1397-1398.
206 Annual Report 2008
300 Seifert, B., Rubin, G., Wit, N.J. de, Lionis, C., Hall, N., Hungin, P., Jones, R., Palka, M. & mendive, J
(2008). The management of common gastrointestinal disorders in general practice. A survey by the
European Society for Primary Care Gastroenterology (ESPCG) in six European countries. Digestive
and liver disease, 40(8), 659-666.
301 Siccama, R.N., Janssen, K.J.M., Oudega, R., Delden, J.J.M. van & Moons, K.G.M. (2008). D-dimer
testing in elderly patients in primary care for exclusion of venous thromboembolism. Journal of
Thrombosis and Haemostasis, 6(11), 1972-1973.
302 Sieri, S., Krogh, V., Berrino, F., Pala, V., Thiebaut, A., Tjonneland, A., Olsen, A., Overvad, K., Jakobsen,
M.U., Clavel-Chapelon, F., Chajes, V., Boutron-Ruault, M.C., Kaaks, R., Linseisen, J., Boeing, H.,
Nothlings, U., Trichopoulou, A., Naska, A., Lagiou, P., Panico, S., Palli, D., Vineis, P., Tumino, R., Lund,
E., Kumle, M., Skeie, G., Gonzalez, C.A., Ardanaz, E., Amiano, P., Tormo, M.J., Martinez-Garcia, C.,
Quiros, J.R., Berglund, G., Gullberg, B., Hallmans, G., Lenner, P., Bueno-de-Mesquita, H.B.,
Duijnhoven, F.J.B van, Peeters, P.H.M., Gils, C.H. van, Key, T.J., Crowe, F., Bingham, S, Khaw, K.T.,
Rinaldi, S., Slimani, N., Jenab, M., Norat, T. & Riboli, E. (2008). Dietary fat and breast cancer risk in
the European Prospective Investigation into Cancer and Nutrition. American Journal of Clinical
Nutrition, 88(5), 1304-1312.
303 Sliedrecht, A., Elzen, W.P. den, Verheij, Th.J.M., Westendorp, R.G.J. & Gussekloo, J. (2008). Incidence
and predictive factors of lower respiratory tract infections among the very elderly in the general
population. The Leiden 85-plus Study. Thorax, 63(9), 817-822.
304 Smeets, R.J., Vlaeyen, J.W.S., Hidding, A., Kester, A.D., Heijden, G.J.M.G. van der, Geel, A.C. van &
Knottnerus, prof.dr. J.A. (2008). Active rehabilitation for chronic low back pain: cognitive-behavioral,
physical, or both? First direct post-treatment results from a randomized controlled trial. BMC
Musculoskeletal Disorders [E], 20(7), 5.
305 Smeets, R.J., Vlaeyen, J.W.S., Hidding, A., Kester, A.D.M., Heijden, G.J.M.G. van der & Knottnerus,
J.A. (2008). Chronic low back pain: Physical training, graded activity with problem solving training,
or both? The one-year post-treatment results of a randomized controlled trial. Pain, 134(3), 263-276.
306 Smet, A.M.G.A. de & Bonten, M.J.M. (2008). Selective decontamination of the digestive tract. Current
Opinion in Infectious Diseases, 21(2), 179-183.
307 Smulders, Y.M., Burgers, J.S., Scheltens, T., Hout, B.A. van, Wiersma, T. & Simoons, M.L. (2008).
Clinical practice guideline for cardiovascular risk management in the Netherlands. Netherlands
Journal of Medicine, 66(4), 169-174.
308 Soedamah-Muthu, S.S, Chaturvedi, N., Pickup, J.C. & Fuller, J.H. (2008). Relationship between
plasma sialic acid and fibrinogen concentration and incident micro- and microvascular complications
in type 1 diabetes. The EURODIAB Prospective Complications Study (PCS)). Diabetologia, 51(3),
493-501.
309 Soedamah-Muthu, S.S, Visseren, F.L.J., Algra, A., Graaf, Y. van der & SMART, Study (2008). The
impact of Type 2 diabetes and microalbuminuria on future cardiovascular events in patients with
clinically manifest vascular disease from the Second Manifestations of ARTerial disease (SMART)
study. Diabetic Medicine, 25(1), 51-57.
310 Sol, B.G., Graaf, Y. van der, Bijl, J.J. van der, Goessens, B.M.B. & Visseren, F.L.J. (2008). The role of
self-efficacy in vascular risk factor management: a randomized controlled trial. Patient Education and
Counseling, 71(2), 191-197.
311 Stadhouder, A., Oner, F.C., Wilson, K.W., Vaccaro, A.R., Williamson, O.D., Verbout, A.J., Verhaar, J.A.,
Klerk, L.W.L. de & Buskens, E. (2008). Surgeon equipoise as an inclusion criterion for the evaluation
of nonoperative versus operative treatment of thoracolumbar spinal injuries. Spine Journal, 8(6), 975-
981.
312 Stadhouder, A., Buskens, E., Klerk, L.W.L. de, Verhaar, J.A., Dhert, W.J.A., Verbout, A.J., Vaccaro, A.R.
& Oner, F.C. (2008). Traumatic thoracic and lumbar spinal fractures: operative or nonoperative
treatment: comparison of two treatment strategies by means of surgeon equipoise. Spine, 33(9), 1006-
1017.
Publications 207
313 Stolk, R.P., Schooneveld, M.J. van, Cruickshank, J.K., Hughes, A, Stanton, A, Lu, J., Patel, A., Thom,
S.A., Grobbee, D.E. & Vingerling, J.R. (2008). Retinal vascular lesions in patients of Caucasian and
Asian origin with type 2 diabetes: baseline results from the ADVANCE Retinal Measurements
(AdRem) study. Diabetes Care, 31(4), 708-713.
314 Störk, S., Bots, M.L., Grobbee, D.E. & Schouw, Y.T. van der (2008). Endogenous sex hormones and
C-reactive protein in healthy postmenopausal women. Journal of Internal Medicine, 264(3), 245-253.
315 Stringer, B., Meijel, B.K.G. van, Vree, W. de & Bijl, J.J. van der (2008). User involvement in mental
health care: the role of nurses. A literature review. Journal of Psychiatric and Mental Health Nursing,
15(8), 678-683.
316 Strohaber, J. & Uiterwaal, C.S.P.M. (2008). In situ measurement of three-dimensional ion densities in
focused femtosecond pulses. Physical review letters, 100((2)), 023002.
317 Stuifbergen, M.C., Delden, J.J.M. van & Dykstra, P.A. (2008). The implications of today’s family
structures for support giving to older parents. Ageing and society, 28, 413-434.
318 Suijkerbuijk, K.P.M., Fackler, M.J., Sukumar, S., Gils, C.H. van, Laar, T. van, Wall, E. van der, Vooijs,
M.A.G.G. & Diest, P.J. van (2008). Methylation is less abundant in BRCA1-associated compared with
sporadic breast cancer. Annals of Oncology, 19(11), 1870-1874.
319 Summeren, M.J.H. van, Hameleers, M., Schurgers, L.J., Hoeks, A.P., Uiterwaal, C.S.P.M., Kruger, T.,
Vermeer, C., Kuis, W. & Lilien, M.R. (2008). Circulating calcification inhibitors and vascular
properties in children after renal transplantation. Pediatric Nephrology, 23(6), 985-993.
320 Summeren, M.J.H. van, Vermeer, C., Engelbert, R.H.H., Schurgers, L.J., Takken, T., Fischer, K. & Kuis,
W. (2008). Extremes in vitamin K status of bone are related to bone ultrasound properties in children
with juvenile idiopathic arthritis. Clinical and Experimental Rheumatology, 26(3), 484-491.
321 Summeren, M.J.H. van, Coeverden, S.C. van, Schurgers, L.J., Braam, L.A., Noirt, F., Uiterwaal, C.S.P.M., Kuis, W. & Vermeer, C. (2008). Vitamin K status is associated with childhood bone mineral
content. British Journal of Nutrition, 100(4), 852-858.
322 Sutton, A., Hope, V.D., Mathei, C., Mravcik, V., Sebakova, H., Vallejo, F., Suligoi, B., Brugal, M.T.,
Ncube, F., Wiessing, L.G. & Kretzschmar, M.E.E. (2008). A comparison between the force of infection
estimates for blood-borne viruses in injecting drug user populations across the European Union: a
modelling study. Journal of Viral Hepatitis, 15(11), 809-816.
323 Thiel, G.J.M.W. van & Delden, J.J.M. van (2008). Phase IV research: innovation in need of ethics.
Journal of Medical Ethics, 34(6), 415-416.
324 Thoolen, B.J., Ridder, D.T.D. de, Bensing, J., Gorter, K.J. & Rutten, G.E.H.M. (2008). Beyond Good
Intentions: the development and evaluation of a proactive self-management course for patients
recently diagnosed with Type 2 diabetes. Health Education Research, Feb(23), 53-61.
325 Tiehuis, A.M., Vincken, K.L., Mali, W.P.T.M., Kappelle, L.J., Anbeek, P., Algra, A. & Biessels, G.J.
(2008). Automated and visual scoring methods of cerebral white matter hyperintensities: relation
with age and cognitive function. Cerebrovascular Diseases, 25(1-2), 59-66.
326 Tiehuis, A.M., Graaf, Y. van der, Visseren, F.L.J., Vincken, K.L., Biessels, G.J., Appelman, A.P.A., Kappelle, L.J., Moll, F.L., Mali, W.P.T.M. & SMART, Study Group (2008). Diabetes increases atrophy
and vascular lesions on brain MRI in patients with symptomatic arterial disease. Stroke, 39(5), 1600-
1603.
327 Tjang, Y.S., Heijden, G.J.M.G. van der, Tenderich, G., Korfer, R. & Grobbee, D.E. (2008). Impact of
recipient’s age on heart transplantation outcome. Annals of Thoracic Surgery, 85(6), 2051-2055.
328 Tjang, Y.S., Heijden, G.J.M.G. van der, Tenderich, G., Grobbee, D.E. & Korfer, R. (2008). Survival
analysis in heart transplantation: results from an analysis of 1290 cases in a single center. European
Journal of Cardio-Thoracic Surgery, 33(5), 856-861.
329 Toll, D.B., Oudega, R., Vergouwe, Y., Moons, K.G.M. & Hoes, A.W. (2008). A new diagnostic rule for
deep vein thrombosis: safety and efficiency in clinically relevant subgroups. Family Practice, 25(1),
3-8.
208 Annual Report 2008
330 Toll, D.B., Janssen, K.J.M., Vergouwe, Y. & Moons, K.G.M. (2008). Validation, updating and impact
of clinical prediction rules: a Review. Journal of Clinical Epidemiology, 61, 1085-1094.
331 Top, J., Banga, J.D., Hayes, R, Willems, R.J.L., Bonten, M.J.M. & Hayden, M.K. (2008). Comparison of
multiple-locus variable-number tandem repeat analysis and pulsed-field gel electrophoresis in a
setting of polyclonal endemicity of vancomycin-resistant Enterococcus faecium. Clinical
Microbiology and Infection, 14(4), 363-369.
332 Top, J., Willems, R.J.L. & Bonten, M.J.M. (2008). Emergence of CC17 Enterococcus faecium: from
commensal to hospital-adapted pathogen. FEMS Immunology and Medical Microbiology, 52(3), 297-
308.
333 Top, J., Willems, R.J.L., Velden, S., Asbroek, M. & Bonten, M.J.M. (2008). Emergence of clonal
complex 17 Enterococcus faecium in The Netherlands. Journal of Clinical Microbiology, 46(1), 214-
219.
334 Trappenburg, J.C.A., Niessink, A., Weert-van Oene, G.H. de, Zeijden, H., Snippenburg, R. van, Peters,
A., Lammers, J.W.J. & Schrijvers, A.J.P. (2008). Effects of Telemonitoring in patients with Chronic
Obstructive Pulmonary disease. Telemedicine Journal and e-Health, 14(2), 138-146.
335 Uijen, J.H.J.M., Duijn, H.J. van, Kuyvenhoven, M.M., Schellevis, F.G. & Wouden, J.C. van der (2008).
Characteristics of children consulting for cough, sore throat, or earache. British Journal of General
Practice, 58(549), 248-254.
336 Uijl, I.E.M. den & Fischer, K. (2008). Including the life-time cumulative number of joint bleeds in the
definition of primary prophylaxis. Thrombosis and Haemostasis, 99, 965-968.
337 Uijl, S.G., Moons, K.G.M., Leijten, F.S.S., Veltman, E.P.H.M., Budde, A. & Donselaar, C.A. van (2008).
Is epilepsy surgery utilized to its full extent? Epilepsia, 49(8), 1480-1481.
338 Uijl, S.G., Leijten, F.S.S., Arends, J.B.A.M., Parra, J, Huffelen, A.C. van & Moons, K.G.M. (2008).
Prognosis after temporal lobe epilepsy surgery: the value of combining predictors. Epilepsia, 49(8),
1317-1323.
339 Vaartjes, C.H., Reitsma, J.B., Bruin, A. de, Berger-van Sijl, M., Bos, M.J., Breteler, M.M., Grobbee, D.E. & Bots, M.L. (2008). Nationwide incidence of first stroke and TIA in the Netherlands. European
Journal of Neurology, 15(12), 1315-1323.
340 Vachon, C.M., Gils, C.H. van, Sellers, T.A., Ghosh, K., Pruthi, S., Brandt, K.R. & Pankratz, V.S. (2008).
Mammographic density, breast cancer risk and risk prediction. Breast Cancer Research, 9(6), 217.
341 Vahanian, A., Alfieri, O.R., Al-Attar, N., Antunes, M.J., Bax, J., Cormier, B., Cribier, A., Jaegere, P.P.T.
de, Fournial, G., Kappetein, A.P., Kovac, J., Ludgate, S., Maisano, F., Moat, N., Mohr, F.W., Nataf, P.,
Pierard, L., Pomar, J.L., Schofer, J., Tornos, P., Tuzcu, M., Hout, B.A. van, Segesser, L.K. Von & Walther,
T. (2008). Transcatheter valve implantation for patients with aortic stenosis: a position statement
from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of
Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular
Interventions (EAPCI).
Simultaneously published in:
342 European Journal of Cardio-Thoracic Surgery, 34(1), 1-8.
343 European Heart Journal, 29, 1463-1470.
344 EuroIntervention. 2008 Aug;4(2):193-9.
345 Van Roosbroeck, S., Li, R., Hoek, G., Lebret, E., Brunekreef, B. & Spiegelman, D. (2008). Traffic-
related outdoor air pollution and respiratory symptoms in children: the impact of adjustment for
exposure measurement error. Epidemiology, 19(3), 409-416.
346 Van Roosbroeck, S., Hoek, G., Meliefste, K., Janssen, N.A.H. & Brunekreef, B. (2008). Validity of
residential traffic intensity as an estimate of long-term personal exposure to traffic-related air
pollution among adults. Environmental Science and Technology, 42(4), 1337-1344.
347 Velden, A.W. van der, Wit, N.J. de, Quartero, A.O., Grobbee, D.E. & Numans, M.E. (2008).
Maintenance treatment for GERD: residual symptoms are associated with psychological distress.
Digestion, 77(3-4), 207-213.
Publications 209
348 Ven, S.M.W.Y. van de, Elias, S.G., Bosch, M.A.A.J. van den, Luijten, P.R. & Mali, W.P.T.M. (2008).
Optical imaging of the breast. Cancer Imaging, 8, 206-215.
349 Venmans-Muller, L.M.A.J., Bont, J., Gorter, K.J., Verheij, Th.J.M., Rutten, G.E.H.M. & Hak, E. (2008). Prediction of complicated lower respiratory tract infections in older patients with diabetes.
British Journal of General Practice, 58(553), 564-568.
350 Vergeer, M., Bots, M.L., Leuven, S.I. van, Basart, D.C., Sijbrands, E.J., Evans, G.W., Grobbee, D.E., Visseren, F.L.J., Stalenhoef, A.F., Stroes, E.S.G. & Kastelein, J.J.P. (2008). Cholesteryl ester transfer
protein inhibitor torcetrapib and off-target toxicity: a pooled analysis of the rating atherosclerotic
disease change by imaging with a new CETP inhibitor (RADIANCE) trials. Circulation, 118(24),
2515-2522.
351 Vergouwe, Y., Klei, W.A. van, Kalkman, C.J. & Moons, K.G.M. (2008). Propensity scores do not
necessarily lie! Anesthesiology, 109(4), 746-747.
352 Vergouwe, Y. & Steyerberg, E.W. (2008). Re: Axel Heidenreich, David Thüer, Sergej Polyakov.
Postchemotherapy retroperitoneal lymph node dissection in advanced germ cell tumours of the testis.
Eur Urol 2008; 53: 260-74. European Urology, 2008(54(4)), 954-955.
353 Verheij, Th.J.M. (2008). De huisarts staat niet met lege handen. Huisarts en Wetenschap, 51(4), 166.
354 Verheugt, C.L., Uiterwaal, C.S.P.M., Velde, E.T. van der, Meijboom, F.J., Pieper, P.G., Vliegen, H.W.,
Dijk, A.P.J. van, Bouma, B.J, Grobbee, D.E. & Mulder, B.J.M. (2008). Gender and outcome in adult
congenital heart disease. Circulation, 118(1), 26-32.
355 Verheugt, C.L., Uiterwaal, C.S.P.M., Grobbee, D.E. & Mulder, B.J.M. (2008). Long-term prognosis of
congenital heart defects: a systematic review. International Journal of Cardiology, 131(1), 25-32.
356 Verheus, M., McKay, J.D., Kaaks, R., Canzian, F., Biessy, C., Johansson, M., Grobbee, D.E., Peeters, P.H.M. & Gils, C.H. van (2008). Common genetic variation in the IGF-1 gene, serum IGF-I levels and
breast density. Breast Cancer Research and Treatment, 112(1), 109-122.
357 Verheus, M., Gils, C.H. van, Kreijkamp-Kaspers, S., Kok, L., Peeters, P.H.M., Grobbee, D.E. &
Schouw, Y.T. van der (2008). Soy protein containing isoflavones and mammographic density in a
randomized controlled trial in postmenopausal women. Cancer Epidemiology Biomarkers &
Prevention, 17(10), 2632-2638.
358 Verkooijen, H.M., Koot, V.C.M., Fioretta, G., Heiden, M. van der, Schipper, M.E.I., Rapiti, E., Peeters, P.H.M., Peterse, J.L. & Bouchardy, C. (2008). Hormone replacement therapy, mammography
screening and changing age-specific incidence rates of breast cancer: an ecological study comparing
two European populations. Breast Cancer Research and Treatment, 107(3), 389-395.
359 Vernooij, F., Heintz, A.P.M., Witteveen, P.O., Heiden-van der Loo, M. van der, Coebergh, J.W. & Graaf, Y. van der (2008). Specialized care and survival of ovarian cancer patients in The Netherlands:
nationwide cohort study. Journal of the National Cancer Institute, 100(6), 399-406.
360 Vesper, H.W., Slimani, N., Hallmans, G., Tjonneland, A., Agudo, A, Benetou, V., Bingham, S, Boeing,
H., Boutron-Ruault, M.C., Bueno-de-Mesquita, H.B., Chirlaque, M.D., Clavel-Chapelon, F., Crowe, F.,
Drogan, D., Ferrari, P., Johansson, I., Kaaks, R., Linseisen, J., Lund, E., Manjer, J., Mattiello, A., Palli,
D., Peeters, P.H.M., Rinaldi, S., Skeie, G., Trichopoulou, A., Vineis, P., Wirfalt, E., Overvad, K. &
Stromberg, U. (2008). Cross-Sectional Study on Acrylamide Hemoglobin Adducts in Subpopulations
from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. Journal of
Agricultural and Food Chemistry, 56(15), 6046-6053.
361 Visscher, S., Schurink, C.A.M., Melsen, W.G., Lucas, P.J.F. & Bonten, M.J.M. (2008). Effects of
systemic antibiotic therapy on bacterial persistence in the respiratory tract of mechanically ventilated
patients. Intensive Care Medicine, 34(4), 692-699.
362 Visscher, S., Kruisheer, E.M., Schurink, C.A.M., Lucas, P.J.F. & Bonten, M.J.M. (2008). Predicting
pathogens causing ventilator-associated pneumonia using a Bayesian network model. Journal of
Antimicrobial Chemotherapy, 62(1), 184-188.
210 Annual Report 2008
363 Vlek, A.L.M., Graaf, Y. van der, Spiering, W., Algra, A., Visseren, F.L.J., Doevendans, P.A., Grobbee, D.E., Kappelle, L.J., Mali, W.P.T.M., Moll, F.L. & Rutten, G.E.H.M. (2008). Cardiovascular events and
all-cause mortality by albuminuria and decreased glomerular filtration rate in patients with vascular
disease. Journal of Internal Medicine, 264(4), 351-360.
364 Vlek, A.L.M., Graaf, Y. van der, Moll, F.L., Spiering, W., Visseren, F.L.J. & SMART, Study Group
(2008). Effect of metabolic syndrome or type II diabetes mellitus on the occurrence of recurrent
vascular events in hypertensive patients [Smart Study Group]. Journal of human hypertension, 22,
358-365.
365 Vliet-Ostaptchouk, J.V. van, Onland-Moret, N.C., Haeften, T.W. van, Franke, L.H., Elbers, C.C., Shiri-
Sverdlov, R., Schouw, Y.T. van der, Hofker, M. & Wijmenga, C. (2008). HHEX gene polymorphisms
are associated with type 2 diabetes in the Dutch Breda cohort. European Journal of Human Genetics,
16(5), 652-656.
366 Vliet-Ostaptchouk, J.V. van, Onland-Moret, N.C., Shiri-Sverdlov, R., Gorp, P.J. van, Custers, A.,
Peeters, P.H.M., Wijmenga, C., Hofker, M.H. & Schouw, Y.T. van der (2008). Polymorphisms of the
TUB gene are associated with body composition and eating behavior in middle-aged women. PLoS
ONE [E], 3(1), e1405.
367 Vlimmeren, L.A. van, Graaf, Y. van der, Boere-Boonekamp, M.M., L’Hoir, M.P., Helders, P.J.M. &
Engelbert, R.H.H. (2008). Effect of Pediatric Physical Therapy on Deformational Plagiocephaly in
Children With Positional Preference. Archives of pediatrics & adolescent medicine, 162(8), 712-718.
368 Vos, A.M. de, Rutten, A., Zaag, H.J. van der, Bots, M.L., Dikkers, R., Buiskool, R.A., Mali, W.P.T.M.,
Lubbers, D.D., Mosterd, A., Prokop, W.M., Rensing, B.J., Cramer, M.J.M., Es, H.W. van, Moll, F.L.,
Pavoordt, E.D. van de, Doevendans, P.A.F.M., Velthuis, B.K., Mackaay, A.J., Zijlstra, F.J. & Oudkerk, M.
(2008). Non-invasive cardiac assessment in high risk patients (the ground study): Rationale,
objectives and design of a multi-center randomized controlled clinical trial. Trials [E], 9(1), 49-49.
369 Vos, A.M. de, Prokop, W.M., Roos, C.J., Meijs, M.F.L., Schouw, Y.T. van der, Rutten, A., Gorter, P.,
Cramer, M.J.M., Doevendans, P.A.F.M., Rensing, B.J., Bartelink, M.E.L., Velthuis, B.K., Mosterd, A. &
Bots, M.L. (2008). Peri-coronary epicardial adipose tissue is related to cardiovascular risk factors and
coronary artery calcification in post-menopausal women. European Heart Journal, 29(6), 777-783.
370 Voskuil, D.W., Vrieling, A., Korse, C.M., Beijnen, J.H., Bonfrer, J.M.G., Doorn, J. van, Kaas, R.,
Oldenburg, H.S.A., Russell, N.S., Rutgers, E.J.T., Verhoef, S., Leeuwen, F.E. van, Veer, L.J. van ‘t &
Rookus, M.A. (2008). Effects of lycopene on the insulin-like growth factor (IGF) system in
premenopausal breast cancer survivors and women at high familial breast cancer risk. Nutrition and
Cancer-an International Journal, 60(3), 342-353.
371 Vrieling, A., Rookus, M.A., Kampman, E., Bonfrer, J.M.G., Bosma, A., Cats, A., Doorn, J. van, Korse,
C.M., Witteman, B.J., Leeuwen, F.E. van, Veer, L.J. van ‘t & Voskuil, D.W. (2008). No effect of red
clover-derived isoflavone intervention on the insulin-like growth factor system in women at increased
risk of colorectal cancer. Cancer Epidemiology Biomarkers & Prevention, 17(10), 2585-2593.
372 Wassink, A.M.J., Graaf, Y. van der, Moll, F.L., Soedamah-Muthu, S.S., Spiering, W. & Visseren, F.L.J.
(2008). Metabolic Syndrome and incidence of type 2 diabetes in patients with manifest vascular
disease [Smart Study Group]. Diabetes and Vascular Disease Research, 5(2), 114-122.
373 Wassink, A.M.J., Graaf, Y. van der, Olijhoek, J.K., Visseren, F.L.J., Moll, F.L. & SMART, Study Group
(2008). Metabolic syndrome and the risk of new vascular events and all-cause mortality in patients
with coronary artery disease, cerebrovascular disease, peripheral arterial disease or abdominal aortic
aneurysm. European Heart Journal, 29(2), 213-223.
374 Weerd, M. de, Buskens, E. & Bots, M.L. (2008). Guidelines for screening of extracranial carotid artery
disease: a comment. Journal of Neuroimaging, 18(1), 105-106.
375 Weerd, N.C. van der, Penne, E.L., Dorpel, M.A. van den, Grooteman, M.P.C., Nube, M.J., Bots, M.L., Wee ter, P.M & Blankestijn, P.J. (2008). Haemodiafiltration: promise for the future? Nephrol Dial
Transplant, 2(23), 438-443.
Publications 211
376 Weert, E. van, Hoekstra-Weebers, J.E., May-de Groot, A.M., Korstjens, I., Ros, W.J.G. & Schans, C.P.
van der (2008). The development of an evidence-based physical self-management rehabilitation
programme for cancer survivors. Patient Education and Counseling, 71(2), 169-190.
377 Weikert, S., Boeing, H., Pischon, T., Weikert, C., Olsen, A., Tjonneland, A., Overvad, K., Becker, N.,
Linseisen, J., Trichopoulou, A., Mountokalakis, T., Trichopoulos, D., Sieri, S., Palli, D., Vineis, P.,
Panico, S., Peeters, P.H.M., Bueno-de-Mesquita, H.B., Verschuren, W.M., Ljungberg, B., Hallmans, G.,
Berglund, G., Gonzalez, C.A., Dorronsoro, M., Barricarte, A., Tormo, M.J., Allen, N., Roddam, A.,
Bingham, S, Khaw, K.T., Rinaldi, S., Ferrari, P., Norat, T. & Riboli, E. (2008). Blood pressure and risk
of renal cell carcinoma in the European prospective investigation into cancer and nutrition. American
Journal of Epidemiology, 167(4), 438-446.
378 Weinmayr, G., Forastiere, F., Weiland, S.K., Rzehak, P., Abramidze, T., Annesi-Maesano, I., Bjorksten,
B., Brunekreef, B., Buchele, G., Cookson, W.O., von Mutius, E., Pistelli, R. & Strachan, D.P. (2008).
International variation in prevalence of rhinitis and its relationship with sensitisation to perennial
and seasonal allergens. European Respiratory Journal, 32(5), 1250-1261.
379 Wermer, M.J.H., Koffijberg, H., Schaaf, I.C. van der, Algra, A., Rinkel, G.J.E. & ASTRA, Studygroup
(2008). Effectiveness and costs of screening for aneurysms every 5 years after subarachnoid
hemorrhage. Neurology, 70(22), 2053-2062.
380 Wermer, M.J.H., Schaaf, I.C. van der, Algra, A. & Rinkel, G.J.E. (2008). Response to letter by van der
Jagt et al (published in the January 2008 issue) (letter). Stroke, 39, e64-e64.
381 Wijk, I. van, Koudstaal, P.J., Kappelle, L.J., Gijn, J. van, Gorter, J.W., Algra, A & LiLAC, Study Group
(2008). Long-term occurrence of death and cardiovascular events in patients with transient ischaemic
attack or minor ischaemic stroke: comparison between arterial and cardiac source of the index event.
Journal of Neurology, Neurosurgery and Psychiatry, 79(8), 895-899.
382 Willers, S.M., Wijga, A.H., Brunekreef, B., Kerkhof, M., Gerritsen, J., Hoekstra, M.O., Jongste, J.C. de
& Smit, H.A. (2008). Maternal food consumption during pregnancy and the longitudinal
development of childhood asthma. American Journal of Respiratory and Critical Care Medicine,
178(2), 113-114.
383 Winters, S.M., Visser, H., Steerneman, A.H., Thomas, G., Bots, M.L. & Heijden, G.J.M.G. van der
(2008). Is there a need for dietary measures to further reduce LDL cholesterol in patients with type II
diabetes mellitus on statin therapy? Primary Care Diabetes, 2(1), 51-54.
384 Wit, N.J. de, Rubin, G. & Jones, R.H. (2008). Irritable bowel syndrome. In Clinical Evidence
Handbook. London: BMJ publishing group.
385 Wulp, I. van der, Baar, M.E. van & Schrijvers, A.J.P. (2008). Reliability and validy of the Manchester
Triage System in a general emergency department patient population in the Netherlands. Emergency
Medicine Journal, 25(7), 431-434.
386 Yli-Tuomi, T., Lanki, T., Hoek, G., Brunekreef, B. & Pekkanen, J. (2008). Determination of the sources
of indoor PM2.5 in Amsterdam and Helsinki. Environmental Science and Technology, 42(12), 4440-
4446.
387 Young, J., Sutter, A. de, Merenstein, D., Essen, G.A. van, Kaiser, L., Varonen, H., Williamson, I. &
Bucher, H.C. (2008). Antibiotics for adults with clinically diagnosed acute rhinosinusitis: a meta-
analysis of individual patient data. Lancet, 371(9616), 908-914.
388 Zaane, B. van, Zuithoff, N.P.A., Reitsma, J.B., Bax, L., Nierich, A.P. & Moons, K.G.M. (2008). Meta-
analysis of the diagnostic accuracy of transesophageal echocardiography for assessment of
atherosclerosis in the ascending aorta in patients undergoing cardiac surgery. Acta Anaesthesiologica
Scandinavica, 52, 1179-1187.
389 Zafarmand, M.H., Schouw, Y.T. van der, Grobbee, D.E., Leeuw, P.W. de & Bots, M.L. (2008). Alpha-
adducin Gly460Trp variant increases the risk of stroke in hypertensive Dutch women. Hypertension,
51(6), 1665-1670.
212 Annual Report 2008
390 Zafarmand, M.H., Schouw, Y.T. van der, Grobbee, D.E., Leeuw, P.W. de & Bots, M.L. (2008).
Peroxisome proliferator-activated receptor gamma-2 P12A polymorphism and risk of acute
myocardial infarction, coronary heart disease and ischemic stroke: a case-cohort study and meta-
analyses. Vascular Health and Risk Management, 4(2), 427-436.
391 Zafarmand, M.H., Schouw, Y.T. van der, Grobbee, D.E., Leeuw, P.W. de & Bots, M.L. (2008). T64A
polymorphism in beta3-adrenergic receptor gene (ADRB3) and coronary heart disease: a case-cohort
study and meta-analysis. Journal of Internal Medicine, 263(1), 79-89.
392 Zafarmand, M.H., Nijdam, M.E., Franx, A., Grobbee, D.E. & Bots, M.L. (2008). The angiotensinogen
gene M235T polymorphism and development of preeclampsia: a meta-analysis and meta-regression
of observational studies. Journal of Hypertension, 26(9), 1726-1734.
393 Zafarmand, M.H., Schouw, Y.T. van der, Grobbee, D.E., Leeuw, P.W. de & Bots, M.L. (2008). The
M235T polymorphism in the AGT gene and CHD risk: evidence of a Hardy-Weinberg equilibrium
violation and publication bias in a meta-analysis. PLoS ONE [E], 3(6), e2533.
394 Zafarmand, M.H., Franx, A., Sabour, S., Schouw, Y.T. van der, Grobbee, D.E., Leeuw, P.W. de & Bots, M.L. (2008). The M235T variant of the angiotensinogen gene is related to development of self-
reported hypertension during pregnancy: Prospect-EPIC Cohort Study. Hypertension Research,
31(7), 1299-1305.
395 Zander, K. van der, Bots, M.L., Bak, A.A.A., Koning, M.M.G. & Leeuw, P.W. de (2008). Enzymatically
hydrolyzed lactotripeptides do not lower blood pressure in mildly hypertensive subjects. American
Journal of Clinical Nutrition, 88, 1697-1702.
396 Zhang, J., Regieli, J.J., Schipper, M., Entius, M.M., Liang, F., Koerselman, J., Ruven, H.J.T., Graaf, Y. van der, Grobbee, D.E. & Doevendans, P.A.F.M. (2008). Inflammatory gene haplotype-interaction
networks involved in coronary collateral formation. Human Heredity, 66(4), 252-264.
397 Zijlmans, G.J.M., Buskens, E., Hersevoort, M., Huiskamp, G.J.M., Huffelen, A.C. van & Leijten, F.S.S.
(2008). Should we reconsider epilepsy surgery? The motivation of patients once rejected. Seizure: the
Journal of the British Epilepsy Association, 17(4), 374-377.
398 Zuidgeest, M.G.P., Smit, H.A., Bracke, M., Wijga, A.H., Brunekreef, B., Hoekstra, M.O., Gerritsen, J.,
Kerkhof, M., Jongste, J.C. de & Leufkens, H.G.M. (2008). Persistence of asthma medication use in
preschool children. Respiratory Medicine, 102(10), 1446-1451.
399 Zuidgeest, M.G.P., Dijk, L. van, Smit, H.A., Wouden, J.C. van der, Brunekreef, B., Leufkens, H.G.M. &
Bracke, M. (2008). Prescription of respiratory medication without an asthma diagnosis in children: a
population based study. BMC Health Services Research, 8, 16.
400 Zuilen, A.D. van, Wetzels, J.F., Bots, M.L. & Blankestijn, P.J. (2008). MASTERPLAN: study of the role
of nurse practitioners in a multifactoral intervention to reduce cardiovascular risk in chronic kidney
disease patients. Journal of Nephrology, 21(3), 261-267.
Professional Publications
1 Algra, A., Schryver, E.L.L.M. de & Halkes, P.H.A. (2008). [Thromboprophylaxis for cerebrovascular
disorders: acetylsalicyclic acid remains the cornerstone.]. Nederlands Tijdschrift voor Geneeskunde,
152(20), 1179-1179.
2 Akkerman, A.E., Verheij, Th.J.M., Grobbee, D.E. & Hak, E. (2008). Interactieve medische informatie
van het Huisartsen Netwerk Utrecht en de Almere Zorggroep. Huisarts en Wetenschap, 51(2), 90-95.
3 Besselink, M.G.H., Santvoort, H.C. van, Buskens, E., Akkermans, L.M.A. & Gooszen, H.G. (2008).
Probiotic prophylaxis in predicted severe acute pancreatitis - Authors’ reply. Lancet, 372(9633), 114-
114.
Publications 213
4 Besselink, M.G.H., Santvoort, H.C. van, Buskens, E., Boermeester, M.A., Goor, H. van, Timmerman,
H., Nieuwenhuijs, V.B., Bollen, T.L., Ramshorst, B. van, Witteman, B.J., Rosman, C., Ploeg, R.J., Brink,
M.A., Schaapherder, A.F., Dejong, C.H. van, Wahab, P.J., Laarhoven, C.J.H.M. van, Harst, E. van der,
Eijck, C.H.J. van, Cuesta, M.A., Akkermans, L.M.A. & Gooszen, H.G. (2008). Probioticaprofylaxe bij
voorspeld ernstige acute pancreatitis: een gerandomiseerde, dubbelblinde, placebogecontroleerde
trial. Nederlands Tijdschrift voor Geneeskunde, 152(12), 685-696.
5 Beus, M.F. de & Mosterd, A. (2008). [Establishment of a national registry for sudden cardiac arrest in
athletes.]. Nederlands Tijdschrift voor Geneeskunde, 152(37), 2037-2038.
6 Bonten, M.J.M. (2008). [Medical microbiology laboratories in Dutch hospitals: essential for safe
patient care. Nederlands Tijdschrift voor Geneeskunde, 152, 2650-2652.
7 Boom, F., Meijel, B.K.G. van, Wesselink, W. & Stringer, B. (2008). Gedeelde smart: het betrekken van
naasten bij de verpleegkundige zorg voor de suïcidale patiënt. Psychopraxis, 10(2), 70-74.
8 Bruggen, J.A.R. van, Gorter, K.J., Stolk, R.P. & Rutten, G.E.H.M. (2008). Alleen door delegeren wordt
de diabeteszorg niet beter. Tijdschrift voor praktijkondersteuning, 1, 187-190.
9 Brunekreef, B. (2008). De lange adem. VVM Milieu, 2, 17-21.
10 Cate, Th.J. ten, Horsman, M.A., Luijk, S.J. van & Scheele, F (2008). Richtlijnen voor het onderwijs in
de medische vervolgopleidingen: waarom en hoe? Tijdschrift voor Medisch Onderwijs, 27(6), 272-
278.
11 Derde, L.P.G. & Hoepelman, I.M. (2008). Wat is de (klinische) betekenis van ondertemperatuur bij
infectieuze aandoeningen en wat is de ondergrens? Longartsen Vademecum, 11(16).
12 Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J.J., Ponikowski, P., Poole-Wilson, P.A.,
Strömberg, A., Veldhuisen, D.J. van, Atar, D., Hoes, A.W., Keren, A., Mebazaa, A., Nieminen, M.,
Priori, S.G. & Swedberg, K (2008). [ESC Guidelines for the Diagnosis And Treatment of Acute And
Chronic Heart Failure 2008] Versión premilinar en fase de revisión. Revista Espanola de Cardiologia,
61(12), 1329.e1-1329.e70.
13 Essen, G.A. van & Sutter, A. de (2008). Hebben volwassenen met acute rhinosinusitis baat bij
behandeling met antibiotica? Huisarts en Wetenschap, 51, 270-274.
14 Galan, B.E. de, Tack, C.J. & Grobbee, D.E. (2008). Iedereen met diabetes heeft recht op
bloeddrukverlaging. Huisarts en Wetenschap, 51(12), 596-597.
15 Geldrop, W.J. van, Numans, M.E., Berg, H.F., Putten, A.M. van, Scheele, M.E. & Bouma, M. (2008).
NHG Standaard virushepatitis en andere leveraandoeningen. Huisarts en Wetenschap, 50(12), 666-
681.
16 Graaf, Y. van der (2008). Echographic screening of the abdominal aorta in older men is not useful.
Nederlands Tijdschrift voor Geneeskunde, 152(13), 751.
17 Hak, E., Opstelten, W., Looijmans-van den Akker, I. & Knottnerus, J.A. (2008). [Influenza
vaccination in the elderly: effectiveness not in doubt] Griepvaccinatie bij ouderen: geen twijfel aan de
effectiviteit. Nederlands Tijdschrift voor Geneeskunde, 152(19), 1081-1083.
18 Halm-Walters, M.M. van, Bijl, J.J. van der & Swieten-Duijfjes, B. van (2008). Van revalidant tot
manager: een literatuurstudie naar zelfmanagement bij personen met een dwarslaesie. Verpleegkunde
: Nederlands-Vlaams wetenschappelijk tijdschrift voor verpleegkundigen, 23(2), 108-117.
19 Hamelink-Baksteen, K., Houben, F.C., Bun, C.J. & Wit, N.J. de (2008). Preventie en reductie van
overgewicht bij kinderen in het basisonderwijs: de effectiviteit van een lokaal multidisciplinair
interventieprogramma. Huisarts en Wetenschap, 13, 651-657.
20 Hoogerduijn, J.G., Weldam, S.W.M. & Schuurmans, M.J. (2008). Ontwikkeling van een senior
gerichte anamnese. TVZ : Tijdschrift voor Verpleegkundigen, 5, 46-49.
21 Isterdael, C.E.D. van, Stilma, J.S., Bezemer, P.D. & Tijmes, N.T. (2008). Determinanten van het al dan
niet behandelen van refractieafwijkingen en cataract bij mensen met een verstandelijke beperking.
Nederlands Tijdschrift voor Geneeskunde, 152(18), 1048-1051.
214 Annual Report 2008
22 Jaarsma, T., Wal, M.H. van der, Lesman-Leegte, I, Luttik, M.L., Hogenhuis, J., Veeger, N.J., Sanderman,
R., Hoes, A.W., Gilst, W.H. Van, Lok, DJ, Dunselman, P.H.J.M., Tijssen, J.G., Hillege, H.L. &
Veldhuisen, D.J. van (2008). [Value of basic or intensive management of patients with heart failure
confirmed in a randomised controlled clinical trial.]. Nederlands Tijdschrift voor Geneeskunde, 52,
2016-2021.
23 Kiemeney, L., Lemmers, F.A., Verhoeven, R.H., Aben, K.K., Honing, C., Nooijer, J. de, Peeters, P.H.M., Visser, O. & Vlems, F.A. (2008). [The risk of cancer in the Netherlands]. Nederlands Tijdschrift voor
Geneeskunde, 152(41), 2233-2241.
24 Koeman, M., Ven, A.J. van der, Hak, E., Joore, J.C.A., Kaasjager, H.A.H., Smet, A.M.G.A. de, Ramsay,
G., Dormans, T.P., Aarts, L.P., Bel, E.E. de, Hustinx, W.N.M., Tweel, I. van der, Hoepelman, I.M. &
Bonten, M.J.M. (2008). Less ventilator-associated pneumonia after oral decontamination with
chlorhexidine; a randomised trial. Nederlands Tijdschrift voor Geneeskunde, 152(13), 752-759.
25 Korstjens, I., May, A.M. & Weert, E. van (2008). Revalidatie voor overlevende van kanker. Tijdschrift
Kanker, 32(6), 14-17.
26 Korstjens, I., May, A.M. & Weert, E. van (2008). Revalidatie voor overlevende van kanker: Positieve
(langetermijn) effecten op kwaliteit van leven. Bulletin / Nederlandse Vereniging voor Psychosociale
Oncologie, 16(3), 10-11.
27 Leusink, P., Boer, L.J. de, Vliet Vlieland, C.W., Rambharose, V.R., Sprengers, A.M., Mogendorf, S.W. &
Rijn-Kortenhoef, N.M.M. van (2008). NHG-standaard Erectiele Dysfunctie. Huisarts en Wetenschap,
51(8), 381-394.
28 Looijmans-van den Akker, I., Opstelten, W., Hak, E., Groeneveld, K.M & Knottnerus, J.A. (2008).
Griepvaccinatie: Advies Gezondheidsraad over griepvaccinatie. Huisarts en Wetenschap, 51(4), 169-
173.
29 May-de Groot, A.M. & Ros, W.J.G. (2008). Het Oncorev onderzoek. Oedeminus, 2, 8-11.
30 Meijel, B.K.G. van (2008). Naar verdere professionalisering van de psychiatrisch verpleegkundige
zorg. Verpleegkunde : Nederlands-Vlaams wetenschappelijk tijdschrift voor verpleegkundigen, 23(2),
139-142.
31 Meijel, B.K.G. van, Hage, S., Fluttert, F.A.J. & Berden, G. (2008). Preventie van agressie bij jeugdigen.
TVZ : Tijdschrift voor Verpleegkundigen, 10, 44-49.
32 Meijel, B.K.G. van (2008). Verpleegkundige zorg bij bipolaire stoornissen. TVZ : Tijdschrift voor
Verpleegkundigen, 118(4), 49-49.
33 Menko, F.H., Hoogebrugge, N., Barneveld, T.A. van, Bleiker, E., Zeelenberg, M., Gille, J.J.P., Jing,
R.H.A. de, Young, I.M.A., Kleibeuker, J.H., Ligtenberg, M.J., Morreau, J., Mourits, M.J.E., Nagengast,
F.M., Sijmons, R.H., Slors, J.F.M., Spijker, H.G. van, Steeg, M. van der, Taminiau, J.A.J.M., Voskuil,
D.W. & Wit, N.J. de (2008). Landelijke richtlijn erfelijke darmkanker.
34 Molenaar, E.A., Numans, M.E., Ameijden, E.J.C. van & Grobbee, D.E. (2008). [Considerable
comorbidity in overweight adults: results from the Utrecht Health Project]. Nederlands Tijdschrift
voor Geneeskunde, 152(45), 2457-2463.
35 Mulder, C.J., Beer, J. de, Beld, M., Blomberg, B.M. von, Groot, A.C. de, Hopman, G.D., Klinken, F. van,
Kolkman, J.J., Loffeld, R.L., Mearin Manrique, M.L., Meyer, J.W., Tonino, M.A., Numans, M.E., Oudkerk Pool, M., Scheenstra, R., Stoof, J.C. & Wahab, P.J. (2008). CBO-richtlijn coeliakie en
dermatitis herpetiformis. Utrecht: CBO.
36 Oosterheert, J.J., Bonten, M.J.M., Schneider, M.M.E., Buskens, E., Lammers, J.W.J., Hustinx, W.N.M.,
Kramer, M.H.H., Prins, J.M., Slee, Ph.Th.J., Kaasjager, K. & Hoepelman, I.M. (2008). [An early switch
from intravenous to oral antibiotics is equally effective as the standard intravenous therapy in severe
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37 Opstelten, W., Essen, G.A. van, Laan, JR van der & Geijer, R.M.M. (2008). Antivirale middelen bij
griep: zelden geindiceerd. Huisarts en Wetenschap, 51, 167-168.
38 Opstelten, W., Essen, G.A. van, Baillieux, M.J.P. & Goudswaard, A.N. (2008). Nog weinig huisartsen
ingeënt tegen de griep. Huisarts en Wetenschap, 51, 610-613.
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39 Opstelten, W., Essen, G.A. van, Laan, JR van der, Geijer, R.M.M. & Goudswaard, A.N. (2008).
[Summary of the practice guideline ‘Influenza and influenza vaccination’ (first revision) from the
Dutch College of General Practitioners] Samenvatting van de standaard ‘Influenza en
influenzavaccinatie’ (eerste herziening) van het Nederlands Huisartsen Genootschap. Nederlands
Tijdschrift voor Geneeskunde, 152(39), 2116-2119.
40 Rossum, T.G.J. van, Melker, H.E. de, Houweling, H., Voordouw, A.C.G., Meijer, C.J.L.M., Helmerhorst,
T.J.M., Kretzschmar, M.E.E., Berkhof, J. & Noordaa, J. van der (2008). [Vaccines against human
papillomavirus (HPV); between registration and implementation]. Nederlands Tijdschrift voor
Geneeskunde, 152(17), 987-992.
41 Rutten, G.E.H.M. (2008). [Care of patients with type 2 diabetes mellitus in primary care]. Nederlands
Tijdschrift voor Geneeskunde, 152(44), 2389-2394.
42 Rutten, G.E.H.M. (2008). Preventie van hart- en vaatziekten bij diabetes mellitus type 2. Modern
Medicine (Nederlandse ed.), 32(9A), 4-8.
43 Rutten, F.H., Cramer, M.J.M., Lammers, J.W.J., Grobbee, D.E. & Hoes, A.W. (2008). NT-proBNP bij
de diagnostiek van hartfalen in de huisartspraktijk bij oudere patiënten met COPD. Hart Bulletin, 39,
112-117.
44 Rutten, F.H. (2008). Patiënten met COPD hebben vaak ook hartfalen. Cordiaal, 1, 19-21.
45 Sachs, A.P.E. (2008). De man die ‘s morgens plotseling met dubbele tong sprak. Nederlands
Tijdschrift voor Allergie, 3, 14-17.
46 Sachs, A.P.E. (2008). Zijn er praktische richtlijnen voortgekomen uit de studies met betrekking tot
preventie van allergische aandoeningen waaronder astma en astma bij kinderen? Nederlands
Tijdschrift voor Allergie, 3, 537-551.
47 Schayck, C.P. van & Sachs, A.P.E. (2008). Onderdiagnostiek van astma en rhinitis in de
huisartspraktijk. Nederlands Tijdschrift voor Allergie, 2, 27-31.
48 Scheltens, T., Grobbee, D.E., Kok, L., Verschuren, W.M.M., Bots, M.L., Numans, M.E. & Hoes, A.W. (2008). Van de NHG-standaard Cholesterol naar de NHG-standaard Cardiovasculair
risicomanagement: en nu? Huisarts en Wetenschap, 51(9), 420-425.
49 Schryver, E.L.L.M. de, Halkes, P.H.A. & Algra, A.. (2008). [No role for oral anticoagulants (target INR;
2.0-3.0) after transient ischaemic attack or cerebral infarction of arterial origin; the European/
Australasian stroke prevention in reversible ischaemia trial (ESPRIT).]. Nederlands Tijdschrift voor
Geneeskunde, 152(8), 445-453.
50 Starreveld, J.S., Zwart, S., Boukes, F.S., Wiersma, T. & Goudswaard, A.N. (2008). [Summary of the
practice guideline ‘Sore throat’ (second revision) from the Dutch College of General Practitioners]
Samenvatting van de standaard ‘Acute keelpijn’ (tweede herziening) van het Nederlands Huisartsen
Genootschap. Nederlands Tijdschrift voor Geneeskunde, 152(8), 431-435.
51 Thiel, G.J.M.W. van (2008). Therapeutische misvatting in klinisch onderzoek. METCforum, 12(1),
3-6.
52 Uijen, J.H.J.M., Duijn, H.J. van, Kuyvenhoven, M.M., Schellevis, F. & Wouden, H. van der (2008).
Kinderen met hoesten, keelpijn en oorpijn. Huisarts en Wetenschap, 51(13), 663-668.
53 Vaartjes, C.H. & Bots, M.L. (2008). Hartfalen: Feiten en cijfers. Hart Bulletin, 39(5), 131-134.
54 Vaartjes, C.H., Dis, SJ van, Peters, R.J.G. & Bots, M.L. (2008). Ingrepen bij hartritmestoornissen,
hartoperaties en percutane coronaire interventies: Cijfers en feiten. Hart Bulletin, 39(1), 21-23.
55 Vaartjes, C.H. & Bots, M.L. (2008). Perifeer arterieel vaatlijden: Feiten en cijfers. Hart Bulletin, 39(6),
161-167.
56 Venekamp, R.P., Melker, R.A. de, Kuyvenhoven, M.M. & Damoiseaux, R.A.M.J. (2008). Vijftig jaar
bovensteluchtweginfecties vóór en dóór huisartsen. Huisarts en Wetenschap, 51(5), 247-250.
57 Verheij, Th.J.M. (2008). De huisarts staat niet met lege handen. Huisarts en Wetenschap, 51(4), 166.
58 Visseren, F.L.J. & Graaf, Y. van der (2008). Twijfel aan het bestaan en de klinische relevantie van
‘nieuwe’ risicodeterminanten voor hart- en vaatziekten is onterecht. Nederlands Tijdschrift voor
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216 Annual Report 2008
59 Vlimmeren, L.A. van, Helders, P.J.M., Graaf, Y. van der, Boere-Boonekamp, M.M., L’Hoir, M.P. &
Engelbert, R.H.H. (2008). State of the arts. Zuigelingenasymmetrie; voorkeurshouding en
deformatieve plagiocefalie. Nederlands Tijdschrift voor Fysiotherapie, 118(4), 95-100.
60 Wassenberg, M.W.M., Bonten, M.J.M., Troelstra, A., Kluytmans, J.A.J.W. & Hopmans, T.E.M. (2008).
[Meticillineresistente Staphylococcus aureus afkomstig uit de veestapel in Nederlandse ziekenhuizen:
risicopatiënten alleen controleren bij eventuele ziekenhuisopname]. Nederlands Tijdschrift voor
Geneeskunde, 152, 2681-2688.
61 Wertheim, H.F.L., Bonten, M.J.M., Kluytmans, J.A.J.W., Vos, M.C., Broek, P.J. van den,
Vandenbroucke-Grauls, C.M.J.E., Troelstra, A. & Ammerlaan, H.S.M. (2008). [Optimaliseren van het
antibioticabeleid in Nederland. XII. SWAB-richtlijn voor de behandeling van MRSA-dragerschap].
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62 Wit, N.J. de (2008). [Rol huisarts bij opsporing colon kanker]. Patient Care. Het tijdschrift voor de
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9 Deutsch, A., Bravo de la Parra, R., Boer, R.J. de, Diekmann, O., Jagers, P., Kisdi, E., Kretzschmar, M.E.E., Lansky, P. & Metz, H. (Eds.). (2008). Mathematical Modeling of Biological Systems, Volume
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16 Kretzschmar, M.E.E. (2008). Infectious Disease Modeling. In Kris Heggenhougen and Quah (Eds),
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17 Loffeld, R. & Numans, M.E. (Eds.). (2008). Handboek Refluxziekte. Utrecht: Academic Publishers.
18 Numans, M.E., Schers, H. & Soons, P.H.G.M. (Eds.). (2008). Leven met Diabetes mellitus type 2 (serie
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19 Roos, N.M. de (2008). Evidence-based Diëtetiek: principes en werkwijze. In M Former-Boon & J.J.
van Duinen (Eds.), Evidence based dietetiek (pp. 13-21). Houten: Bohn Stafleu van Loghum.
20 Roos, N.M. de (2008). Evidence-based Diëtetiek: stap voor stap. In M. Former-Boon & J.J. van Duinen
(Eds.), Evidence based Diëtetiek (pp. 22-42). Houten: Bohn Stafleu van Loghum.
21 Roos, N.M. de (2008). Implementatie van evidence-based dietetiek in de praktijk. In M. Former-Boon
& J.J. van Duinen (Eds.), Evidence based Diëtetiek (pp. 106-115). Houten: Bohn Stafleu van Loghum.
22 Schlösser, F.J.V., Vaartjes, C.H., Heijden, G.J.M.G. van der, Moll, F.L., Verhagen, H.J.M., Muhs, B.E.,
Kardaun, J.W., Bruin, A. de, Reitsma, J.B., Graaf, Y. van der & Bots, M.L. (2008). De kans op
overlijden na een eerste ziekenhuisopname vanwege een geruptureerd aneurysma van de abdominale
aorta. In C.H. Vaartjes, R.J.G. Peters, S.J. van Dis & M.L. Bots (Eds.), Hart- en vaatziekten in
Nederland, 2008. Cijfers over ziekte en sterfte: Nederlandse Hartstichting (pp. 85-97). Den Haag:
Nederlandse Hartstichting.
23 Schlösser, F.J.V., Vaartjes, C.H., Heijden, G.J.M.G. van der, Moll, F.L., Verhagen, H.J.M., Muhs, B.E.,
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overlijden na een electieve behandeling van een abdominaal aorta aneurysma. In C.H. Vaartjes, R.J.G.
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24 Thiel, G.J.M.W. van (2008). Laat Ashley niet meer groeien. In I. de Beaufort, M. Hilhorst, S.
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25 Vaartjes, C.H., Peters, R.J.G., Dis, SJ van & Bots, M.L. (2008). Hart- en vaatziekten in Nederland,
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Nederland naar geslacht. In C.H. Vaartjes, R.J.G. Peters, S.J. van Dis & M.L. Bots (Eds.), Hart- en
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(pp. 9-22). Den Haag: Nederlandse Hartstichting.
27 Vaartjes, C.H., Reitsma, J.B., Bruin, A. de & Bots, M.L. (2008). Verschillen tussen mannen en vrouwen
in sterftekans na een eerste ziekenhuisopname vanwege hartfalen. In C.H. Vaartjes, R.J.G. Peters, S.J.
van Dis & M.L. Bots (Eds.), Hart- en vaatziekten in Nederland, 2008. Cijfers over ziekte en sterfte:
Nederlandse Hartstichting (pp. 55-66). Den Haag: Nederlandse Hartstichting.
218 Annual Report 2008
28 Verheugt, C.L., Uiterwaal, C.S.P.M., Velde, E.T. van der, Meijboom, F.J., Pieper, P.G., Vliegen, H.W.,
Dijk, A.P.J. van, Bouma, B.J, Grobbee, D.E. & Mulder, B.J.M. (2008). Verschillen in klinische uitkomst
tussen mannen en vrouwen met aangeboren hartafwijkingen. In C.H. Vaartjes, R.J.G. Peters, S.J. van
Dis & M.L. Bots (Eds.), Hart- en vaatziekten in Nederland, 2008. Cijfers over ziekte en sterfte (pp. 41-
53). Den Haag: Nederlandse Hartstichting.
29 Wit, N.J. de, Rubin, G. & Jones, R.H. (2008). Irritable bowel syndrome. In Clinical Evidence
Handbook. London: BMJ publishing group.
Publications 219
Nederlandse Samenvatting 2008
Nederlandse Samenvatting 223
Inleiding
Het Julius Centrum voor Gezondheidswetenschappen en Eerstelijns
Geneeskunde heeft een eenvoudige strategie. Doe alles wat noodzakelijk
is om uitmuntend onderzoek en onderwijs in de gezondheidsweten-
schappen te realiseren. Ondanks het feit dat onze successen op het
gebied van onderzoek lijken te overheersen, zijn we ervan overtuigd dat
de basis van onze prestaties in de wetenschap en gezondheidszorg wordt
gevormd door hoogwaardig onderwijs.
In 2008 vonden verschillende veranderingen plaats binnen de organisa-
tie. De lijnorganisatie werd versterkt en de coördinatoren van de vijf
onderzoekslijnen kregen meer verantwoordelijkheden. Daarnaast heb-
ben het management van het Julius Centrum en de Raad van Bestuur
van het UMC Utrecht na zorgvuldige overweging besloten om de
Clinical Trial activiteiten onder te brengen in een aparte onafhankelijke
academische onderzoeksorganisatie: Julius Clinical Research B.V.
Verder werd in 2008 het vroegere universitaire Centrum voor
Biostatistiek opgenomen in het Julius Centrum en vertrok de afdeling
Verplegingswetenschap.
In 2008 werden op het gebied van onderwijs en onderzoek heel wat suc-
cessen geboekt. Een record aantal studenten studeerde af bij de vakoplei-
ding Huisartsgeneeskunde en het MSc programma Epidemiologie. Ook
met het aantal afgeronde proefschriften vestigde het Julius Centrum een
nieuw record. Maar liefst 39 kandidaten verdedigden hun proefschrift
met een staflid van het Julius Centrum als (co-)promotor. Rick Grobbee
werd voor de vierde keer ‘PhD Supervisor of the Year’ met een totaal van
meer dan 100 promovendi die hij succesvol hun proefschrift liet verde-
digen. Daarnaast waren de stafleden van het Julius Centrum betrokken
224 Annual Report 2008
bij 400 internationale wetenschappelijke publicaties, waarvan 10 in de
vooraanstaande tijdschriften The Lancet, New England Journal of
Medicine en JAMA. De wetenschappelijke positie van het Julius
Centrum werd verder benadrukt door de toekenning van twee belangrij-
ke prijzen, de Heineken en de Catharijne prijs, aan respectievelijk de
professoren Bert Brunekreef en Rick Grobbee.
Nederlandse Samenvatting 225
Organisatie
Vanaf het ontstaan in 1996 is het Julius Centrum gegroeid zowel qua
grootte als qua werkgebied. Het Centrum werd aanvankelijk opgericht
door het samenvoegen van de afdelingen Epidemiologie en Public
Health en de verpleegafdeling van Klinische Epidemiologie. In 1999 wer-
den de afdelingen Huisartsgeneeskunde en Patiënt-gericht Onderzoek
toegevoegd. Het huidige Julius Center voor Gezondheidswetenschappen
en Eerstelijns Geneeskunde ontstond door de toevoeging van de afdelin-
gen Verplegingswetenschap en Voedingswetenschappen in 2002.
Meerdere ontwikkelingen hebben plaatsgevonden binnen de organisatie
in 2008. Biostatistiek werd toegevoegd aan het Centrum om opleiding
en onderzoek op dit gebied te versterken. Door reorganisatie werd de
discipline Verplegingswetenschap opgeheven binnen het Julius Centrum.
Daarnaast werd een aantal activiteiten van de Clinical Trial Unit onder-
gebracht bij een onafhankelijke organisatie, Julius Clinical Research, die
zich bezighoudt met de uitvoering van grootschalige trials.
226 Annual Report 2008
Onderzoek
Het onderzoek van het Julius Centrum valt binnen het UMC program-
ma Epidemiologie. Binnen dit programma levert het Julius Centrum de
voornaamste bijdrage aan het totale onderzoek van het UMC Utrecht.
Daarnaast draagt het Julius Centrum bij aan de vier ziekte-gerelateerde
onderzoeksgebieden van het UMC Utrecht: hart- en vaatziekten, infec-
tieziekten en immunologie, kanker en geestelijke gezondheid. Tot slot is
het Julius Centrum ook betrokken bij de twee andere methodologische
onderzoeksthema’s van het UMC Utrecht, te weten beeldwetenschappen
en genomics.
Onderzoek binnen het Julius Centrum is georganiseerd volgens een
matrixstructuur zoals die van het UMC Utrecht. Langs de horizontale as
de wetenschappelijke disciplines; Klinische Epidemiologie, Huisarts-
geneeskunde, Public Health, Biostatistiek, MTA, Medische Ethiek,
Voedingswetenschappen en Verplegingswetenschap. Langs de verticale as
staan de hierboven genoemde vier ziekte-gerelateerde onderzoekslijnen
met daaraan toegevoegd een methodologische onderzoekslijn.
Het Julius Centrum heeft formele banden met de volgende afdelingen/
groepen binnen de Universiteit Utrecht: het interfacultaire Institute for
Risk Assessment Sciences (IRAS), Environmental and Occupational
Epidemiology, farmaco-epidemiologie en veterinaire epidemiologie.
Het Julius Centrum geeft methodologisch advies en ondersteuning voor
klinisch onderzoek aan vrijwel alle afdelingen van het UMC. Stafleden
worden ingezet als adviseurs voor onderzoeksmethoden zowel binnen
als buiten het UMC Utrecht.
Nederlandse Samenvatting 227
Onderzoekslijnen
Hart- en vaatziekten
Deze onderzoekslijn is de meest omvangrijke van de vier onderzoekslij-
nen binnen het Julius Centrum. Het onderzoek maakt gebruik van epi-
demiologische onderzoeksmethoden, zoals multi-centered randomized
controlled trials om de effecten van preventief en therapeutisch ingrij-
pen te onderzoeken, en cohort, case-control en cross-sectional onder-
zoek. De nadruk ligt op oorzaken, diagnose, prognose en behandeling
van hart- en vaatziekten.
Het onderzoek naar hart- en vaatziekten is geconcentreerd rond een
aantal thema’s.
1 Factoren vroeg in het leven die de kans op hart- en vaatziekten
vergroten
2 Endocrinologische aspecten van hart- en vaatziekten
3 Internationale trials
4 Diagnose en prognose van hart- en vaatziekten in de eerstelijn
5 Vasculaire complicaties bij type 2 diabetes mellitus in de eerstelijns
zorg
6 Voorspellen van recidief hart- en vaatziekten
7 Diagnose en prognose van atherosclerose
8 Preventie van complicaties na een eerste vasculaire cerebrale ziekte
9 Epidemiology van hemofilie
Belangrijk onderzoek wordt verricht op het raakvlak met huisartsge-
neeskunde, aangezien de huisarts de portier is van de Nederlandse
gezondheidszorg. Daarom is diagnose in de eerstelijns zorg een belang-
rijk onderzoeksonderwerp zowel in het algemeen binnen het Julius
Centrum als bij deze onderzoekslijn. In dit kader werd in de AMUSE
studie gekeken naar het effect van een diagnostische voorspellingsregel
228 Annual Report 2008
in de eerstelijns zorg bij het vaststellen van diepe veneuze trombose in
het been. Deze studie werd in 2008 succesvol afgesloten. In 2008 werd
ook gestart met de multi-center studie FAME, waarbij gekeken wordt
naar diagnose in de eerstelijns zorg van acuut coronair syndroom.
Het Julius Centrum is sinds 1996 betrokken bij het cohort onderzoek
SMART betreffende patiënten met een hoog risico op cardiovasculaire
ziekte (CVD). In 2008 werden vijf proefschriften die voortkwamen uit
dit onderzoek succesvol verdedigd en kreeg het onderzoek een vervolg in
SMART-2. Daarnaast werd in 2008 een grootschalig onderzoek gestart
dat erop gericht is hart- en vaatziekten al op jonge leeftijd te diagnostice-
ren en te voorkomen.
Infectieziekten
Het onderzoek naar infectieziekten is geconcentreerd rond vier onder-
werpen:
1 Voorkomen, diagnose en prognose van infecties van de
ademhalingswegen
2 Doeltreffendheid van vaccinatiestrategieën
3 Mathematische modellen van infectieziekten
4 Effecten van ziekenhuisinfecties en de overdracht van antibiotica-
resistente bacteriën op patiënten
Kanker
Het kankeronderzoek binnen het Julius Centrum richt zich op de oor-
zaak, vroege diagnose en prognose van hormoon-gerelateerde kanker,
met name bij vrouwen. Het onderzoek naar de oorzaken richt zich met
name op de interactie tussen genen, hormonen en levensstijl.
Nederlandse Samenvatting 229
Er is een nauwe samenwerking met de afdeling Epidemiology and Public
Health aan de medische faculteit van het Imperial College London,
Verenigd Koninkrijk, waar het hoofd van de kanker onderzoekslijn van
het Julius Centrum, Petra Peeters, voor 1 dag in de week als professor is
aangesteld.
Geestelijke Gezondheid
De sectie psychiatrische epidemiologie van het Julius Centrum onder-
zoekt psychiatrische ziekten en de daaraan gerelateerde comorbiditeit in
eerstelijns zorg en onder de bevolking in het algemeen. Het onderzoek
kan worden onderverdeeld in drie aandachtsgebieden:
1 Presentatie van depressie in eerstelijns zorg en de relatie met
lichamelijke ziekten zoals dementie, diabetes, maag-darmziekten en
vaatziekten
2 Functionele ziekten en somatoforme aandoeningen
3 Psychiatrische morbiditeit gerelateerd aan sociodemografische
context en consultatie patronen.
De benadering van het onderzoek van het fenomeen somatische psychi-
atrische co-morbiditeit op verschillende niveau’s van het systeem van de
gezondheidszorg is uniek. De meeste onderzoeksprojecten worden uitge-
voerd in samenwerking met partners in de eerstelijns- of tweedelijns
gezondheidszorg, en vaak in samenwerking met andere (internationale)
academische centra.
Theoretische Epidemiologie en Biostatistiek
Het Julius Centrum richt zich op het ontwikkelen van de theorie en
methodologie van epidemiologisch onderzoek. Theoretische epidemio-
logie houdt zich bezig met onderzoek naar het verbeteren van bestaande
230 Annual Report 2008
methoden en ontwikkelt innovatieve methoden voor de opzet en analyse
van epidemiologische studies.
De verbetering van bestaande methoden voor de opzet en analyse van
multivariabel diagnostisch en prognostisch onderzoek is vrij uniek. De
methoden worden niet alleen bestudeerd op een puur theoretisch
niveau, maar worden tevens toegepast door gebruik van empirische data
van verschillende medische disciplines binnen het Julius Centrum en
van andere grootschalige studies binnen het UMC Utrecht.
Samenwerkingsverbanden
Het Julius Centrum heeft een groot netwerk en heeft een groot aantal
structurele samenwerkingsverbanden. Meerdere mensen hebben hun
persoonlijke naam verbonden aan het centrum via een ereaanstelling.
Binnen het UMC Utrecht zijn gecombineerde aanstellingen van perso-
neel bij verschillende disciplines gerealiseerd om zo een nauw contact te
realiseren met de klinische praktijk bij zowel het formuleren van onder-
zoeksvragen, het uitvoeren van onderzoek als de implementatie van
verworven kennis. Er zijn nauwe banden met alle epidemiologische
onderzoeksgroepen binnen de Universiteit Utrecht zoals IRAS, farmaco-
epidemiologie en veterinaire epidemiologie. Daarnaast zijn er structu-
rele banden met het Rijksinstituut voor Volksgezondheid en Milieu
(RIVM).
Onderzoek in het Julius Centrum wordt uitgevoerd in samenwerking
met onderzoeksinstituten en universiteiten in veel landen. Er bestaan
verscheidene structurele lange termijn samenwerkingsverbanden zoals
de Europese EPIC studie en het GRACE project. Andere vormen van
samenwerking vinden plaats op projectbasis. Momenteel lopen er meer
dan veertig internationale onderzoeksprojecten. Het centrum richt zich
Nederlandse Samenvatting 231
daarnaast op het ontwikkelen van intensieve structurele lange termijn
partnerships met strategisch geselecteerde vooraanstaande en hoogwaar-
dige academische instituten zoals het Imperial College London, Boston
University en het George Institute for International Health in Sydney.
Deze en andere contacten zijn van groot belang bij het verwezenlijken
van de ambitie van het Julius Centrum: voorop blijven lopen in het
internationaal gezondheidswetenschappelijk onderzoek en het versprei-
den van kennis onder een internationaal publiek van studenten en
gezondheidsprofessionals.
IRAS
Het Institute for Risk Assessment Sciences (IRAS) is een interfacultair
onderzoeksinstituut binnen de Universiteit Utrecht dat zich bezighoudt
met interdisciplinair onderzoek dat zich richt op het vaststellen van risi-
co’s van chemische, natuurlijke en biologische middelen op de mens en
zijn omgeving. Het onderzoek wordt uitgevoerd binnen drie divisies:
Environmental Epidemiology, Toxicology en Veterinary Public Health.
De inbreng van de IRAS in samenwerkingsprojecten heeft betrekking op
‘exposure assessment’ methodologie en geavanceerde ‘exposure response’
modellering.
UU Research Focus Area Epidemiology & the Utrecht Centre for
Infection Dynamics (UCID)
Gebaseerd op de aandachtsgebieden van de faculteit, heeft de
Universiteit Utrecht 15 thematische onderzoeksclusters geselecteerd.
Deze aandachtsgebieden bestaan uit multidisciplinaire clusters die voor-
aanstaande onderzoeksgroepen uit elk thematisch veld samenbrengen.
Eén van deze vijftien gebieden is epidemiologie waarin epidemiologische
onderzoeksgroepen samenwerken.
232 Annual Report 2008
Onderwijs
Het Julius Centrum neemt deel aan een grote hoeveelheid onderwijspro-
gramma’s in een breed scala aan gezondheidswetenschappen en eerste-
lijns zorg. Het centrum neemt actief deel aan nieuwe ontwikkelingen op
het gebied van onderwijs, zoals het ambitieuze undergraduate medicine
program (CRU’99) van het UMC Utrecht, gestart in 1999 en gebaseerd
op interdisciplinair probleem-georiënteerd leren en aan SUMMA, een
nieuw 4-jarig master programma dat startte in 2004. Het merendeel van
de onderwijsprogramma’s wordt gegeven samen met andere divisies bin-
nen of buiten het UMC Utrecht. Het centrum is de basis van het enige
Nederlandse graduate programma voor verplegingswetenschap. Het
centrum is onder andere ook verantwoordelijk voor de specialistenoplei-
ding tot huisarts voor artsen in een driejarige vakopleiding. Speciaal is
ook het nieuwe opleidingsprogramma voor een master titel in de epide-
miologie dat in 2004 werd opgestart samen met andere faculteiten van
de Universiteit Utrecht. Onderwijs voor onderzoekers van het Julius
Centrum vindt plaats door middel van deelname aan erkende graduate
schools zoals het Nihes (Netherlands Institute of Health Science).
Contracten met het management van het Nihes leidden tot een intensie-
vere samenwerking op het gebied van marketing en werving van master
studenten en een voorstel voor een gezamenlijke website voor de
Masteropleiding in Epidemiologie programma. Elk jaar groeit het aantal
onderwijsprogramma’s en dit jaar is een nieuw programma ontwikkeld
voor het medisch curriculum (Medical Humanities) dat is opgenomen
in het curriculum vanaf september 2008.
Huisartsgeneeskunde is een belangrijke specialisatie in Nederland. De
medewerkers van Huisartsgeneeskunde in het Julius Centrum nemen
deel aan diverse onderwijsprogramma’s en geven cursussen op verschil-
Nederlandse Samenvatting 233
lende niveau’s in de basis van het medisch curriculum (Bachelor,
Master). Daarnaast is er een vakopleiding (Post-Graduate) en doorlo-
pend medisch onderwijs. Ook neemt het Julius Centrum actief deel aan
de Bachelor, Master, Post-Graduate/vakopleiding (waar van toepassing)
en vervolgopleidingen op het gebied van Epidemiologie, Public Health,
Biostatistiek, Medical Humanities, Verplegingswetenschap en
Voedingswetenschap.
Binnen het onderwijs vinden verschillende internationale activiteiten
plaats. Deze variëren van het uitnodigen van internationale gastsprekers
en het onderbrengen van internationale studenten tot het organiseren
van onderwijsactiviteiten in het buitenland. Verschillende onderwijsacti-
viteiten in het Julius Centrum zijn Engelstalig en trekken buitenlandse
studenten aan, zoals het MSc programma Epidemiologie of de cursussen
die worden georganiseerd in het door de EU gefinancierde Interact pro-
gramma. Daarnaast verzorgde het Julius Centrum in 2008 verschillende
klinische epidemiologie cursussen in landen zoals Maleisië, Indonesië,
Japan, Canada en de VS.
234 Annual Report 2008
Patiëntenzorg
Voedingswetenschap en Diëtetiek
De afdeling Voedingswetenschap en Diëtetiek bestaat uit twee groepen.
Voedingswetenschap heeft als hoofdactiviteit onderwijs, onderzoek en
advies op het gebied van kwaliteitszorg. Diëtetiek richt zich op patiën-
tenzorg en het verbeteren van patiëntenzorg.
Voedingswetenschap richt zich op het verbeteren van de integratie van
evidence-based voedingsinterventies in de geneeskunde. In het doorlo-
pend onderwijs aan (para)medische professionals werd voorzien door
bijdragen aan vakbladen en lezingen op nationale congressen. Voor
onderzoeksdoeleinden werd een voedsel-frequentie vragenlijst verbeterd
en is men bezig deze vragenlijst online beschikbaar te maken.
Diëtetiek voorziet in en verbetert patiëntenzorg in het UMC Utrecht en
het revalidatiecentrum ‘De Hoogstraat’. Diëtetiek is landelijk koploper
op het gebied van evidence-based diëtetiek en gestandaardiseerde pro-
cessen voor diëtetiek professionals. De implementatie van een elektro-
nisch patiëntendossier in 2007 verliep voorspoedig en was de start van
een proces van innovatie en efficiëntie. In de loop van 2008 werd het sys-
teem op meerdere punten verbeterd en werden verbindingen gemaakt
met andere elektronische dossiers in het UMC Utrecht. Eveneens werd
er een automatische correspondentie naar specialisten en partners in de
eerstelijns zorg, andere ziekenhuizen en verzorgingstehuizen ontwikkeld.
Daarnaast nam de sectie Diëtetiek deel aan een groot aantal externe
(internationaal, nationaal en regionaal) en interne projecten, workshops,
presentaties en cursussen.
Nederlandse Samenvatting 235
Academische eerstelijns zorg: Julius gezondheidscentra Leidsche Rijn
Sinds januari 2004 heeft het Julius Centrum een netwerk voor academi-
sche patiëntenzorg, gesitueerd in het recent ontwikkelde Utrechtse dis-
trict ‘Leidsche Rijn’. In de komende paar jaar zal Leidsche Rijn uitbreiden
naar een groter voorstedelijk gebied met ongeveer 80.000 inwoners.
Eén van de ambities van het Julius Centrum is het creëren van een aca-
demische omgeving in de eerstelijns zorg waar onderzoek en medisch
onderwijs worden gecombineerd met hoogwaardige, innovatieve patiën-
tenzorg. Om dit te bewerkstelligen heeft het Julius Centrum de ontwik-
keling van eerstelijns zorgfaciliteiten in Leidsche Rijn, het VINEX gebied
van Utrecht, sinds 2004 aangestuurd. In 2008 werden meer dan 20.000
inwoners voorzien van eerstelijns zorgdiensten vanuit de vier Julius
gezondheidscentra. Hiervoor hadden de Julius gezondheidscentra 20
huisartsen, 10 fysiotherapeuten en ondersteunend verplegend en admi-
nistratief personeel in dienst.
In 2008 gingen de centra de volgende fase in hun academische ontwik-
keling in, hetgeen uiteindelijk zal leiden tot een volledige implementatie
van de academische infrastructuur in 2012.
Unit Innovations in Health Services
De unit richt zich op onderzoek naar geïntegreerde zorg en ziektebeheer
en onderzoek naar hulpdiensten. In 2008 groeide de unit van 17 naar 25
fulltime professionele medewerkers. De unit verkreeg zes toewijzingen
voor onderzoek uit diverse fondsen en was betrokken bij tien congressen
en zeven cursussen. Daarnaast werden er twee proefschriften, elf publi-
caties en vele rapporten gepubliceerd. Over 2008 had de unit een positief
financieel resultaat.
236 Annual Report 2008
Operationele ondersteuning
Management Support
De kernactiviteiten van het Julius Centrum, onderzoek, onderwijs en
patiëntenzorg, worden ondersteund door een aantal diensten. Het
management wordt ondersteund door een centrale financiële afdeling,
een P&O afdeling en een ICT afdeling. Het Julius Centrum is in hoge
mate afhankelijk van externe fondsen zoals die van de European Counsel
en van Nederlandse onderzoeksfondsen zoals ZonMw. De Julius
Centrum website is verder vernieuwd in 2008.
Van CTSU naar Julius Clinical Research en Research Support
In het eerste half jaar van 2008 hield de Clinical Trial Services Unit
(CTSU) net zoals in de jaren daarvoor zich bezig met project manage-
ment, monitoring, een researchkliniek, kwaliteitsborging, een helpdesk
en in het voorzien van een technische infrastructuur voor het verzame-
len, verwerken en analyseren van data. Aan het einde van 2008 werd ech-
ter gestart met de overdracht van een gedeelte van de clinical trial activi-
teiten, te weten project management en klinische monitoring, aan Julius
Clinical Research (JCR), een nieuw opgerichte onafhankelijke academi-
sche trial organisatie. Research support diensten zoals onderzoekskli-
niek, data management, kwaliteitsborging en het Vascular Imaging
Centrum blijven deel uitmaken van het Julius Centrum.
Clinical Trial and Services Unit (CTSU)
CTSU bestond tot het najaar van 2008. CTSU diensten waren beschik-
baar voor interne (Julius Centrum) en externe sponsors. Externe spon-
sors konden andere divisies van het UMC Utrecht, farmaceutische en
voedingsbedrijven of andere wetenschappelijk instituten (RIVM, TNO,
Nederlandse Samenvatting 237
NVI) zijn. De diverse onderdelen van CTSU werden in 2008 opnieuw
gecertificeerd volgens ISO 9001:2000.
Research Support
Onderzoekskliniek
De onderzoekskliniek is een out-patient onderzoekscentrum dat volledig
is uitgerust met moderne klinische en diagnostische faciliteiten voor het
uitvoeren van klinische trials in overeenstemming met GCP richtlijnen.
De onderzoekskliniek was in 2008 betrokken bij 25 studies.
Data Management
Data Management voorziet in gegevensbeheer van hoogwaardige kwali-
teit volgens GCP normen om het verzamelen, verwerken, beheren en
analyseren van epidemiologische gegevens te vergemakkelijken. Deze
diensten zijn beschikbaar voor een brede groep klanten: onderzoekers
van het Julius Centrum en de onderzoekskliniek, onderzoekers van
andere UMC Utrecht divisies en externe partijen. Aan het einde van
2008 liepen er ongeveer 90 projecten binnen deze afdeling.
Kwaliteitsborging
Het Julius Centrum voorziet in diensten in klinisch onderzoek die in
overeenstemming zijn met ICH-GCP en andere van toepassing zijnde
richtlijnen en wetgeving. Het Julius Centrum is verantwoordelijk voor
het Quality Assurance Systeem voor klinische drug trials uitgevoerd in
het UMC Utrecht (Bureau Kwaliteitsborging Onderzoek - BKO).
Vascular Imaging Center
Het VIC is een laboratorium faciliteit die een aantal vasculaire metingen,
met nadruk op ultrasone technieken, ondersteunt. De activiteiten van
het VIC omvatten onder andere de ontwikkeling van meetprotocollen,
238 Annual Report 2008
advies over apparatuur, het uitvoeren van feitelijke metingen, training
op locatie en certificering. Sinds de start van het VIC in 1997 zijn er
meer dan 20.000 vasculaire metingen bij ongeveer 6.500 patiënten uitge-
voerd.
Julius Clinical Research B.V.
In juli 2008 werd Julius Clinical Research B.V. opgericht. Deze organisa-
tie profileert zichzelf als een academische CRO (ARO), die zich wijdt aan
het leveren van klinische trials van hoogwaardige kwaliteit aan zowel de
farmaceutische industrie als de academische wereld. In 2008 werden
contract onderhandelingen gestart en met succes afgerond tussen het
UMC Utrecht en Wyeth Pharmaceuticals voor het uitvoeren van een
mega-trial op het gebied van infectieziekten: de CAPiTA trial. Door de
snelle gang van zaken werd besloten om de CTSU staf pas in de eerste
helft van 2009 over te laten gaan naar Julius Clinical Research.
Nederlandse Samenvatting 239
Tot slot
De overeenkomstige onderdelen van het jaarverslag gaan dieper in op de
bovengenoemde onderwerpen. Daarnaast geeft het jaarverslag informa-
tie over de medewerkers van het Julius Centrum, de financiële stand van
zaken, lopende onderzoeksprojecten en niet te vergeten de publicaties
van 2008.
240 Annual Report 2008
Colophon
Editor: Mireille Donkervoort, Manon Kluijtmans
Production: Hellen Braun, Giene de Vries
Design and lay out: Frank Boesveld, Multimedia, UMC Utrecht
Photography: Chris Timmers, Multimedia, UMC Utrecht
Printing: ZuidamUithof drukkerijen, Utrecht
Circulation: 1000
August 2009
University Medical Center Utrecht
Julius Center for Health Sciences and Primary Care
Management Team
Organizational structure
Chair: Prof DE Grobbee, MD PhDDirector of Research: Prof AW Hoes, MD PhDDirector of Education: Prof Y van der Graaf, MD PhDDirector of Business and Operations: M van der Starre, MSc (until August 2008)Ir BC van Lieshout (until 31 Dec 2008)Executive Secretary:M Kluijtmans, PhD
Clinical Epidemiology Coordinator: Prof Y van der Graaf, MD PhD
Leidsche Rijn, Julius Health Care CentersDirector: RAE van Damme, MD
Unit Health Care Innovations Head: Prof AJP Schrijvers, PhD
DieteticsHead: M de Bruin
Clinical Trial Services UnitHead: AAA Bak, MD PhD- Project Management Head: AAA Bak, MD PhD- Vascular Imaging Center Head: KM Nijssen- Monitoring Head: IEM Sikking- Site Management Head: L Vendrig
Data ManagementHead: RER Veen, MSc
Management Support Head: M van der Starre, MSc (until August 2008) Ir BC van Lieshout (a.i.)- Finances Head: MH Bekkers - ICT Head: RER Veen, MSc- P&O JJ Molenaar- Facilities Space Manager: JH ter Keurs- Communication M van der Werff
Research Theme: Cardiovascular Diseases Coordinator: ML Bots, MD PhD / YT van der Schouw, PhD
Theme: Infectious Diseases Coordinator: Prof MJM Bonten, MD PhD
Theme: Cancer Coordinator: Prof PHM Peeters, MD PhD
Theme: Mental Health Coordinator: NJ de Wit, MD PhD
Theme: Theoretical Epidemiology and Biostatistics Coordinator: Prof KGM Moons, PhD
Education
Courses:
Patient Care
OperationalSupport
MSc Epidemiology
Medical School / Bachelor and Master Programmes / Research Schools / Postgraduate Education
Coordinator: GJMG van der Heijden, PhD
Coordinator: HM Pieters, MD PhD
Coordinator: RW Haneveld, PHS MPH
Coordinator: JJ van der Bijl, PhD
Coordinator: JA Iestra, PhD
Coordinator: CLJJ Kruitwagen, MSc
Full Curricula: MSc Nursing ScienceGeneral Practice Vocational Training
Biostatistics Coordinator: vacancy
NutritionalSciences
Nursing Scienceuntil mid 2008
Public Health / MTA / Medical EthicsCoordinator:PH: Prof AJP Schrijvers, PhDMTA: GA de Wit, PhDMedical Ethics: Prof JJM van Delden, MD, PhD
General PracticeCoordinator: Prof ThJM Verheij, MD PhD
University Medical Center Utrecht
Julius Center for Health Sciences
and Primary Care
Address:
Heidelberglaan 100
3584 CX Utrecht
The Netherlands
Correspondence:
P.O. Box 85500
3508 GA Utrecht
The Netherlands
Phone +31 (0)88 75 681 81
Fax +31 (0)88 75 680 99
www.umcutrecht.nl
www.juliuscenter.nl