Annual Report 2005 Julius Center for Health Sciences and Primary Care

Annual Report 2005
Julius Center for Health Sciences and Primary Care
Annual Report 2005
Julius Center
for Health Sciences and Primary Care
Colophon
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 for a leading and acquisitive position in the enlargement and
dissemination of knowledge, especially in the field of health sciences. This is done by
means of groundbreaking research into four disease-related themes and into research
methodology, and by the provision of courses for (bio)medical students, researchers
and clinicians.
Disciplines represented in the Center are general practice, (clinical) epidemiology,
nursing science, medical technology assessment, public health, and nutritional sciences.
In this annual report the reader will find information on activities, output and finances
in 2005.
Contact information:
M. Kluijtmans, PhD, Education and Research Strategy
& Coordinator Master Programme Epidemiology
Julius Center for Health Sciences and Primary Care
University Medical Center Utrecht
Visitors: Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
Correspondence: Str.6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
URL: www.juliuscenter.nl
E-mail: [email protected]; [email protected]
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Julius Center for Health Sciences and Primary Care
Contents
Introduction
5
Organization
Brief history
Organizational structure
9
9
Research
Research organization
Research themes
Research services, vascular imaging center, data management
IRAS
International collaboration
10
10
13
22
24
25
Education
Overview
Medical school
BSc Biomedical sciences
29
29
31
32
MSc Biomedical sciences, masterprogramme Epidemiology
MA Applied ethics
MSc Nursing science
General practice vocational training
Graduate schools (UGS Life Sciences, Nihes, ImageO,
Eijkman and P&H
Advanced training in public health
Advanced training in general practice
Advanced training in clinical epidemiology
Annual Report 2005
34
36
37
40
42
45
46
48
3
Patient care
Nutritional sciences and dietetics
Julius Center health care Leidsche Rijn
49
49
52
Business and operations
54
Personnel and finances
Personnel, figures
Personnel, listing
Financial report
56
56
57
65
Research projects 2005
Cardiovascular diseases
Infectious diseases
Cancer
Mental health
Research methodology and biostatistics
Miscellaneous
Research services
68
68
72
74
76
79
81
83
Vascular imaging center (VIC)
Data managament
Publications 2005
PhD theses
Books and book chapters
Professional publications
International publications
4
Julius Center for Health Sciences and Primary Care
85
86
88
88
91
98
106
Introduction
Since the Julius Center was established in 1996, it has built up a solid
reputation in research and education. More recently the center
broadened its ambition to obtain a similar reputation in patient care.
The designation of epidemiology as a main research theme by the
University Medical Center underlines the prominent role the center has
played in applied research 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, the Center
plays an active role in providing methodologic advice and in the
facilitation of clinical research across virtually all departments of the
University Medical Center.
In 2005 the center has further expanded its activities in the coordination
and conduct of multinational and multicenter clinical trials supported
by the ISO certified department of Research Services. Internationally, an
alliance is being formed with like-minded and well-reputed academic
institutes in Australia and the USA. The advantage of the three institutes
operating together is their joint ability to offer complementary expertise
and a documented management and recruitment capacity for trials
which virtually spans the globe. Trials by the alliance can be conducted
efficiently, using harmonized protocols and standard operating
procedures in different countries and five continents. The Academic
Alliance for Clinical Trials offers a valuable academic partnership to
large international pharmaceutical companies and its ambition is to
become a major player in the field in the coming years.
On a more local scale, but of similar importance for the quality and
extent of the trial activities of the Center, the board of the UMC
Annual Report 2005
5
Utrecht has agreed on a dedicated rol for the the Research Services
department of the Julius Center in all clinical trials in which
departments of the hospital engage. The Center’s contribution in
facilitating and promoting the quality of trials in the hospital is
herewith formalized and the number of trials supported and
monitored by the Research Services department is expected to increase
significantly.
As in previous years, the academic staff succeeded in maintaining
scientific output on a high level both in terms of quality and quantity,
even in times of reduced overall funding of research and increased
competition. Major efforts have been made in maintaining competitive
research funding on a high level. This definitely refers to the quality and
perseverance of those staff members who managed to secure significant
external funding again. As in 2004, the quality of published research
output was not only reflected in citation scores, but also in the awarding
of prestigious NWO research grants to members of the faculty of the
Center: E. Hak received a Veni award and M. Geerlings a Vidi award.
In the course of 2005 the recently acquired responsibility for health
care centers in Leidsche Rijn, an expanding new residential area of
Utrecht, required much attention by the management because of
organizational and financial backlogs and threats. With combined
efforts and firm support by the UMC Utrecht, as well as by other
health care partners in the region, economic and managerial
perspectives have much improved and these centers are now starting to
show the much desired synergetic effects eventually culminating in a
true and nationally unique academic workplace for excellence in care,
research and education. For the staff of General Practice this now
enables to combine medical practice with scientific work as part of the
6
Julius Center for Health Sciences and Primary Care
same academic appointments. The Julius Health Care Centers
permanently house several trainees of the vocational training
programme. In addition, several projects regarding innovation in
health care have been initiated, such as the collaboration with other
primary and secondary health care providers in care-chains for specific
groups of patients.
After intensive discussions, the board of the University Medical Center
decided to follow the advice of an ad-hoc committee that was asked to
analyze the current scientific situation and future perspectives of the
department of Nursing Science. The advice proposes to concentrate on
a more limited number of research topics with a greater emphasis on
internationally competitive results. In 2005 Prof Mieke Grypdonck
retired after having spent many years on promoting nursing science
and help to establish its present position in Utrecht. The University
Medical Center Utrecht had to set up a search committee for a new
chair and allocated resources to strengthen the position of the group.
The Center’s educational activities in 2005 were marked by major
developments. The GP vocational training started a renewed
curriculum which focusses strongly on application of skills in practice,
in addition to competence and theoretical knowledge. The master
progam Nursing Science went through a major revision in which the
previous four year part-time study program was transformed into a
one year pre-master track and a two year part-time master phase. The
research master program in epidemiology, a collaboration of four
epidemiological research groups at Utrecht University, was extended
with a postgraduate, condensed curriculum. Moreover, only one year
after its start, this master program was awarded the exclusive ‘Prestige
Master’ label of Utrecht University. Major added benefits for the Julius
Annual Report 2005
7
Center of participating in the program are the resulting more intensive
collaborations with other research groups at Utrecht University (UU),
a better visibility within UU and, most of all, the creation of a pool of
international and well-educated students from which new talents can
be drawn for future PhD fellowships.
The management and business organization of the Julius Center was
restructured to be able to support the rapidly expanded division. The
changing tasks and challenging environment led to a turbulent year,
with rewards but inescapably also some difficulties and conflicts. After
a period of intensive rebuilding, particularly in terms of personal
relations and communication, the results of this process of renewal and
contemplation is now becoming visible, both in terms of enhanced
transparency and improved control in the Centers’ business affairs.
All in all, 2005 was again a productive and successful year in which
the Center, like a large tree, has shown a modest increase in size, and
developed a ninth year ring. It has further extended its roots and
strengthened its position in the University Medical Center Utrecht.
Moreover, it has solidified its base by giving necessary attention to its
management and business organization and investing in consolidation.
The center has grown several new branches and leaves of research, care
and educational activities. All of this is due to only one factor, its great
people. None of this would have been possible without the
commitment, hard work, inspiration and devotion of many. A word of
thanks to all involved and contributing to the continued success of the
Julius Center is highly appropriate and deeply meant.
Prof. Diederick E. Grobbee, MD, PhD
Chair
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Julius Center for Health Sciences and Primary Care
Organization
Brief history
The Julius Center for patient-oriented research was established on
16 December 1996, building upon the previous department of
epidemiology and public health, and the hospital unit of clinical
epidemiology. Both scope and size have since then markedly increased,
as is reflected by the Julius Centers’ subheadings, not in the least
because other departments have been integrated in the current 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 Julius Center for Health Sciences and
Primary Care. In 2006 the Center will celebrate its tenth anniversary.
Annual Report 2005
9
Research
Research organization
The University Medical Center Utrecht has formulated seven main
research themes .These form a matrix structure with four diseaserelated themes on the horizontal and three methodological themes on
the vertical axis. The Julius Centers’ main contribution to the total
body of research of the UMC Utrecht is through the epidemiological
research theme. With rare exceptions all research of the Center can be
classified as epidemiological. From this as a starting point, the Julius
Center contributes to all four disease-related areas of research: heart
and vascular diseases, infections and immunity, cancer, and mental
health. Moreover, there is also a collaboration with the other two
methodogical research themes, image sciences and genomics
Within the Julius Center itself, research is similarly organized in a
matrix structure. The vertical axis is formed by the scientific disciplines
of the Center: clinical epidemiology, general practice, MTA/public
health/medical ethics, nursing science, and nutritional sciences
(research within all of these disciplines can be largely categorized as
‘epidemiological’ which was the incentive for all these disciplines to be
combined into one Center). The horizontal axis comprises the four
UMC defined disease-based fields of interest; heart and vascular
disease, infectious diseases, cancer, and mental health. Within these
fields, there is a further focus on subfields, such as research on
(etiology and complications of) diabetes mellitus. As from 2005 a fifth,
methodological, research line has been formulated. Of course research
into theoretical epidemiology and biostatistics is not truly new in the
Center: the appointment of Prof. Carl Moons on a personal chair, in
combination with his NWO VIDI research grant, and two
10 Julius Center for Health Sciences and Primary Care
methodologically orientated NWO VENI grants awarded to staff
members Maroeska Rovers and Eelko Hak, have marked a significant
increase in the volume of methodological research and justify the
delineation of a dedicated research line within this field.
The Center’s policy is to concentrate its own research as much as
possible on the matrix’s intersections so that the disciplines within the
Center maximally strengthen the scientific themes of the UMC Utrecht
as a whole and cross-fertilize each other where possible.
DISCIPLINES
THEMES
General Practice (GP)
Clinical Epidemiology (CE)
Nursing Science (NS)
Nutritional Sciences (Dietetics, DT)
Public Health /MTA/Ethics
(PH/MTA)
Cardiovascular Diseases
Infection and Immunity
Cancer
Mental Health
Methodology
(Miscellaneous)
The Julius Center is formally linked with the interfacultary Institute for
Risk Assessment Sciences (IRAS), environmental and occupational
epidemiology at UU by the joined appointment of Prof Bert
Brunekreef and honorary appointment of Prof Dick Heederick. There
is also a collaboration with other epidemiological research groups at
Utrecht University, in particular with Pharmaco the Epidemiology and
Veterinary Epidemiology groups.
In addition to its own research, staff members act as consultants for
research methods on a range of clinical investigations within and
outside the UMC Utrecht. This is an important and growing activity
Annual Report 2005 11
for the Julius Center. With several clinical departments the intense
interaction with epidemiology has resulted in joint appointments of
staff, including with the departments of anaesthesiology, neurology,
cardiology, cardio-thoracic surgery, internal medicine, psychiatry,
radiology and pediatrics.
12 Julius Center for Health Sciences and Primary Care
Research themes
Cardiovascular diseases
A considerable part of the research carried out at the Julius Center
focuses on the causes, diagnosis, prognosis and therapy of
cardiovascular diseases. The approaches include the full range of
epidemiological research methods, including multi-centered
randomized controlled trials to study the effects of preventive and
therapeutic interventions. One example is research on the influence of
natural of synthetic sex hormones on the condition of the heart and
blood vessels in postmenopausal women and elderly men. ADVANCE
is an example of one of the larger international multi-centered
cardiovascular trials the Julius Center is involved in. The Center
coordinates a large number of other multi-center international
cardiovascular prevention and treatment
trials (also see: ‘Research services and Vascular imaging center’).
Increasingly, research includes genetic information and the interplay
between genes and environment as, for example, in studies on genetic
and non-genetic factors that determine the prognosis of patients with
vascular diseases. The studies are conducted in close collaboration with
partners within and outside the UMC Utrecht and abroad.
A unique cohort study of patients at high risk of cardiovascular disease
(CVD) was started in Utrecht in 1996, the Second Manifestations of
ARTerial disease (SMART) Study. All patients referred to the UMC
Utrecht who either have a high risk of CVD (hypertension,
hyperlipidemia, diabetes) or clinically manifest vascular disease
(ischaemic 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 program to detect
Annual Report 2005 13
asymptomatic atherosclerotic lesions and to identify risk factors. Then,
a multidisciplinary team formulates a treatment plan, consistent with
evidence-based medicine, to reduce the patient’s risk of future
cardiovascular events and this treatment advice is sent to the patient’s
general practitioner and to the treating hospital specialist. In addition,
patients are carefully monitored to identify future occurrences of
cardiovascular disease. Currently, more than 6,000 patients have been
enrolled in the study, and the scientific output includes more than 30
papers in peer-reviewed journals.
Furthermore, the Center is involved in the setting up and scientific
evaluation of both diagnostic and therapeutic heart failure outpatient
departments in the broader Utrecht region. The purpose of this is to gain
a better understanding of the nature and causes of heart failure and to
improve early detection and adequate treatment and follow-up of this
syndrome, which constitutes an increasing burden in our ageing society.
Various cardiovascular studies are also being carried out on diabetes
mellitus patients and on the metabolic syndrome. The Research Group
on Diabetology conducts several trials in large` networks of general
practices, notably in the adherence region of the Stichting Huisartsen
Laboratorium Etten Leur and the Apeldoorn Region. In collaboration
with Cambridge University (UK) and Aarhus University (Denmark) the
ADDITION-trial has been set up, a five years follow-up RCT to study
the effects on cardiovascular morbidity and mortality of intensive
multi-factorial treatment in 3,000 screen detected diabetes patients.
Other studies include the early roots of cardiovascular disease in the
young, the etiology and prognostic role of coronary collateral
formation, and the risk-benefit ratio of anticoagulation in patients at a
high risk of stroke.
In addition, the Julius Center is increasingly involved in the execution
of large scale diagnostic studies, aimed at improving the early detection
14 Julius Center for Health Sciences and Primary Care
of cardiovascular diseases, both in the population at large and patients
presenting to primary care of hospital. These include studies on the
added value of, e.g., various diagnostic imaging techniques and early
(bed-side) biomarkers in recognizing atherosclerotic disease (such as
stroke, coronary artery disease, heart failure, peripheral arterial disease)
as well as deep venous thrombosis.
Infectious diseases
Infectious diseases research at the Julius Center is primarily centered
on the prevention, diagnosis and prognosis of respiratory tract
infections. For example, research is being carried out to establish
whether or not certain patient characteristics are predictive with regard
to an abnormal and serious clinical progression of bronchial infections,
and the consequences for treatment and patient advice. In addition,
antibiotic use and indications for prescribing in general practice are
being studied. In this area, research has also been expanding into 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.
Infections in patients with diabetes mellitus are also being studied in
the Research group on Diabetology. Currently the project “Development
and evaluation of an educational program on the prevention of
complicated infections in patients with diabetes’ is carried out. It
focuses on respiratory and urinary tract infections. New research topics
include the treatment of urinary tract infections and the relationship
between onychomycosis and the diabetic foot.
New research topics include the dynamics of influenza, both within
and outside health care settings, with a special emphasis on the
opportunities to prevent spreading through vaccination and preemptive therapy. Furthermore, the cost-effectiveness of infection
Annual Report 2005 15
control strategies in hospitals (such as “search & destroy” for MRSA)
will be studied.
Cancer
Cancer research at the Julius Center focuses on the etiology, early
diagnosis and prognosis of hormone dependant cancer, predominantly
in women. With approximately 30,000 new cases a year amongst Dutch
women, cancer is a serious health threat. However, the known causes
can explain barely 30% of the cases encountered. An explanation for
this rather low percentage may be sought in the fact that environmental
and hormonal factors are predominantly studied without any
consideration to genetic predisposition. Cancer etiological research
within the Julius Center strongly focuses on the interaction between
genes, hormones and the environment (or 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, Prospect-EPIC and
DOM.
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 procedures in women with non-palpable breast
cancer. Studies to assess ‘quality of life’ and evaluate ‘nurse
practitioners’ in the daily care of cancer patients also fall in the domain
of the oncology research at the Julius Center.
Mental health
The section psychiatric epidemiology of the Julius Center studies
psychiatric disease and related co-morbidity in primary care and the
16 Julius Center for Health Sciences and Primary Care
general population. Mental illness represents a sizeable proportion of
the global burden 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 is though closely linked to somatic ill-health - traditionally studied in
isolation. The section psychiatric epidemiology 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 and vascular disease.
2. Functional disease and somatisation: presentation, determinants and
treatment in primary care
3. Psychiatric morbidity in relation to socio-demographic context and
consultation patterns
4. Nurse delegated interventions in mental health care
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 on several levels
(psychological, physical and physiological).
These themes are studied on the various levels at which disorders
manifest themselves:
Annual Report 2005 17
a) the general population, by using existing and developing sampling
frames such as LRGP (Leidsche Rijn Gezondheidsproject),
NEMESIS (Netherlands Mental Health Survey and Incidence
b)
c)
d)
e)
Study), AGIS health database and others.
Primary health care, in primary care networks such as HNU
(Huisartsen Netwerk Utrecht), PREDICT and Julius
Gezondheidscentra.
Populations of people with reported mental illness like those
registered in our psychiatric case registry (RIPAG).
Populations of people with reported somatic illness, such as samples
of cardiovascular compromised patients (SMART), (pre)diabetic
patients (UDES), and medication-using people (PHARMO).
Populations of primary care emergency attenders like the
Huisartsenpost Gelderse Vallei and the emergency department of
the UMC Utrecht
This approach of studying the phenomenon of somatic psychiatric
comorbidity on various levels of the health care system is unique. It
will yield information not only on the etiology of somatic-psychiatric
comorbidity but also on its implications for the health care system.
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 and gastro-enterology,
departments of nursing sciences, often in cooperation with other
(international) academic centers.
Research methodology and biostatistics
Besides more applied studies on improving insights in the etiology,
diagnosis, prognosis and therapy of specific disorders, the Julius Center
18 Julius Center for Health Sciences and Primary Care
also aims to further develop the theory and methodology of the
discipline itself. The section Methodology conducts studies aiming to
improve existing methods and to develop innovative methods for
design and analysis of (clinical) epidemiological studies. The section
focuses on the following themes:
1. Developing innovative designs for diagnostic and prognostic
(prediction) research.
2. Developing innovative methods for quantifying the true value of
(new) diagnostic and prognostic tests in a multivariable clinical
context.
3. Developing innovative methods for the validation and updating of
so-called clinical prediction rules.
4. Testing and improving sophisticated methods for dealing with
missing values in epidemiologic research.
5. Investigating innovative methods for meta-analysis and individual
patient data-analysis of therapeutic studies.
6. Development of models to combine data from randomised and
observational studies including genetic information, for estimating
(long term) prognosis according to specific patient characteristics in
addition to treatment effects.
Notably the improvement of methods for design and analysis of
multivariable diagnostic and prognostic research is unique. Most
research in this field focuses on single test evaluations rather than
evaluations in a clinical context, accounting for other test results. But
also the methodology for modeling data from randomised and nonrandomised studies combined, is in its infancy. This type of research is
situated at the crossroad of clinical epidemiology and medical
technology assessment.
Annual Report 2005 19
All above methodological themes are not only studied on a purely
theoretical level, but are also illustrated by using empirical data from
various medical disciplines, notably from the four disease-oriented
sections of the Julius Center. For example, data are used from the
above-mentioned LRGP (Leidsche Rijn Gezondheidsproject), the
Predict study and the AMUSE study, and from other large ongoing
studies in the UMC Utrecht. It may be obvious that the results of our
methodological studies do not only serve the clinical domains studied,
but may serve all medical domains in which e.g. diagnosis, prognosis
and therapy are at issue.
Most methodological projects are carried out in close collaboration
with other clinical departments from the UMC Utrecht. However, also
with other epidemiological and (bio)statistical departments from
national an international academic centers, 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)
and Oxford University (UK).
Miscellaneous
Several research projects do not directly relate to the core themes of
research of the Julius Center. Some of these projects have their roots in
former research environments of staff members, others originate from
particular areas of expertise from staff members. For example, The
Research Group on Diabetology conducts several projects that are
especially relevant for diabetes care in the primary care setting, for
example projects regarding the effectiveness of a behavioural
intervention in screen detected diabetes patients (in collaboration with
the research group Psychology and Health) or the effects of a
20 Julius Center for Health Sciences and Primary Care
computerised support system for diabetes care.
Most of these projects are initiated from outside the Julius Center, and
staff members are asked to collaborate or (co)supervise the research
with an external party. The general policy is not to promote research
outside the main themes. In the case of contributing expertise, the
Julius center is obviously happy to consider advice and contribute, in
particular when requested by other departments of the UMC Utrecht
and affiliated institutions, and even when this occasionally addresses
other areas.
Annual Report 2005 21
Research services, vascular imaging center,
data management
Studies supported by Research Services, VIC and/or data management,
are carried out on the initiative of Julius Center or in collaboration
with other academic centers (investigator-driven studies) or the
pharmaceutical industry. This cluster of service activities is available for
researchers at the Julius Center. Other researchers at the University
Medical Center Utrecht can also take advantage of the expertise and
facilities.
Research Services, Vascular Imaging Center and Data management
have been certified according to ISO 9001:2000 since January 2005.
The Julius Center has a leading position in a project on the design of a
Quality Assurance System for clinical drug trials performed in the
UMCU. The plan has been approved by the Board of the UMCU and
the Julius Center has responsibility for further implementation and
execution of the Quality Assurance Activities.
Research services
The Julius Center has a research services unit and the infrastructure to
support various scientific research projects, in particular clinical trials, in
the efficient design and implementation, in which the Julius Center has
considerable experience. The services include project management,
monitoring (14 projects in 2005) and an outpatient research center (14
projects in 2005). The outpatient research center is equipped with the
necessary facilities for carrying out clinical trials in accordance with ICH
Good Clinical Practice guidelines. Monitoring activities are performed for
both national and international studies (up to 15 European countries).
22 Julius Center for Health Sciences and Primary Care
Vascular imaging center
The Vascular Imaging Center (VIC) is a core laboratory facility that
supports all steps required in a vascular project, comprising
development of protocols, advice on equipment, performing actual
measurements, training and certification of technicians, continuous
quality assurance and quality control programs during the study,
quantitative QC/QA, reading of stored images, data management,
statistical analyses and scientific reporting. Extensive expertise is
available for (dynamic) measurements of the carotid artery and retinal
vessels. In 2005 there were 8 ongoing projects in the VIC.
Data management
Data management provides a technical infrastructure for the collection,
processing and analysis of epidemiological data. The department
provides these services for the research conducted by the Julius Center,
but also for other divisions of the UMC Utrecht as well as external
parties.
This year Data management participated in about 75 studies, 31 of
which are carried out in cooperation with Research Services and the
Vascular Imaging Center. The activities include data management for
eight cohorts (pertaining to mental health care, oncology and general
practice). In 2005 19 studies were started.
In 2005 the department started the development of a web-based
research system (Research Online Platform) in collaboration with
Mediportaal. In 2006 the system will be used for GRACE, the first pan
European primary care research network focussing on the challenge of
treating respiratory tract infections in an era of emerging antibiotic
resistance. GRACE is financed by the European Union.
Annual Report 2005 23
IRAS
IRAS, the Institute for Risk Assessment Sciences (IRAS), is an
interfaculty research institute within the faculties of Veterinary
Medicine, Medicine and Biology of Utrecht University. The institute
has a dual, complementary mission: it performs interdisciplinary
research concentrating on aspects of risk assessment of the effects of
chemical, physical and biological agents on man and the environment
and also provides education and training in the disciplines of
toxicology, environmental and occupational health and the
epidemiology of graduate and postgraduate (Ph.D.) students. The
research is performed in three divisions; Environmental and
Occupational Health, Toxicology, Public Health and Food Safety.
Research within the Environmental and Occupational Health and
(Veterinary) Public Health and Food Safety Divisions is determinantoriented 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
methodology and advanced exposure response modeling. Specific areas
of research are cancer and exposure to ultrafine particulate matter and
polycyclic aromatic compounds, asthma and allergen exposure, and
modification by exposure to 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.
24 Julius Center for Health Sciences and Primary Care
International collaboration
By nature of its scientific and educational activities the playing field of
the Julius Centers is the world. Research is conducted in collaboration
with research institutes and universities in many different countries. In
addition to the inspiring and productive contacts between staff members
and fellows, the Center aims to establish more extensive long-term
structural partnerships with strategically selected high quality
institutions. These contacts will play an important role in the ambition
of the Julius Center to stay at the forefront of the international academic
world.
With the specific aim to expand its activities in major outcome trials, an
international alliance was created in collaboration with the George
Institute for International Health in Sydney, Australia, and the Berman
Center for Outcomes and Clinical Research, University of Minnesota,
Minneapolis, US. The Academic Alliance for Clinical Trials (www.
academicalliance.com) is an academic contract research organization with
a focus on interaction between pharmaceutical industry and academic
investigators to promote high-quality innovative phase III and phase IV
clinical trials. The Alliance builds upon an existing network of clinics and
health care centers in five continents. Apart for designing and conducting
research, the Alliance invests in improving the methodology an efficiency
of research with ample attention to studies in the developing world.
In international education there is a growing collaboration between the
Julius Center and the Malaysian Ministry of Health, and the University
of Malaya Medical Center (UMMC), Kuala Lumpur, Malaysia. Until
now the collaboration was predominantly based on short intensive
teaching courses on clinical epidemiology and evidence-based
Annual Report 2005 25
medicine, delivered by Julius faculty in collaboration with local staff in
Kuala Lumpur. In 2006 we obtained a grant (commissie
Internationalisering UMC Utrecht) to extend this collaboration to
cover three domains: a) Collaborativeresearchin particular clinical trials
and cohort studies, b) Development and creation of a regional research
infrastructure, c) Expansion of educational programmes also focusing
on the South Asian region.
With regard to clinical trials South East Asia, and Malaysia in
particular, offers an excellent competitive environment for innovative
pharmaceutical companies and large scale studies, as well as a growing
burden of chronic diseases that require attention. The interest of our
partners in Malaysia fits in well with the research interests of the Julius
Center and combining forces creates unique opportunities. The
Ministry of Health, Medical technology assessment has very good
connections with all major hospitals in the country. In 2006 the
partners will jointly
create a research infrastructure in Kuala Lumpur reflecting the
philosophy of the Julius Center to establish a “Julius Center-KL”. In
order to foster high quality of research, a robust research-support
section is needed in which project managers, research nurses, data
managers, computer experts, trial monitors, and administrative
personnel, have their basis. In cooperation with local staff the Julius
Center will continue and broaden the program of short courses on the
methods of clinical research. These courses are targeted to medical
doctors and clinical investigators in the South East Asian region.
Eventually, these courses will be largely taken over by local staff. An
important purpose of these courses is also the scouting and selection of
bright young medical doctors for PhD fellowships. These PhD
fellowships will be supervised by the Julius staff and imbedded in the
26 Julius Center for Health Sciences and Primary Care
research lines of both the UMCU and the UMMC. During the
fellowship candidates will follow part of their education in the
Netherlands, notably in the prestige master program. Depending on
the subject, research will be carried out at the Julius Center or in their
home country.
In addition to clinical trials, the Julius Center also participates in the
largest on-going observational study on nutrition and health in
Europe, the EPIC Study. The European Prospective Investigation into
Cancer and Nutrition started with the collection of extensive dietary
questionnaires, anthropometric measurements and blood samples in
10 European countries between 1992 and 1998. The Julius Center
sampled over 17,000 women. In addition to cancer, (healthy) longevity
(EPIC-Elderly), cardiovascular diseases (EPIC-heart), and diabetes have
been included as major endpoints. There is a strong cooperation with
23 research centers of oncology institutes, universities and public
health institutes over Europe.
In addition to the above-mentioned examples of recent more extensive
initiatives, international collaboration exists 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
●
Departements of Epidemiology and Nutrition, Harvard School of
Public Health, Boston, USA.
●
Department of Cancer Epidemiology, Imperial College, London,
UK
Annual Report 2005 27
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
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.
Department of Public Health, Wake Forest University, Winston
Salem, USA.
Depts. 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.
28 Julius Center for Health Sciences and Primary Care
Education
Overview
Participation in numerous educational programs covering various
aspects of health sciences or primary care is a core-business of the
Julius Center, whose main activities are research and education.
Combined research and educational tasks guarantee teaching on a high
up-to-date level in all disciplines. The Center is, among other things,
responsible for the specialist training of medical doctors as general
practitioners in a three-year vocational training program. Furthermore
the Center is home to the only Dutch graduate program for nursing
science. The Center also actively participates in new educational
developments such as the UMC Utrecht’s ambitious undergraduate
medicine program (CRU’99), which started in 1999 and is based on
interdisciplinary problem-oriented learning, and SUMMA, a new 4year medical grade program that started in 2004. The majority of
educational programs are provided in co-operation with other
divisions within or outside the University Medical Center Utrecht.
Notably, a new training program for masters in epidemiology was
started in 2004 in close collaboration with other faculties of Utrecht
University. Education for the benefit of researchers at the Julius 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).
Annual Report 2005 29
Postgraduate education
General Practice Vocational Training
Graduate Schools (Nihes, ImagO, I&I, P&H)
Post-academic education
Advanced training in Public Health
Advanced training in General Practice
Advanced training in Epidemiology
Public Health /MTA/
Med Ethics
General Practice
Nursing Science
Nutritional Sciences
Graduate education
Medical School (CRU’99 and SUMMA)
MA Applied Ethics
MSc Nursing Science
MSc Epidemiology
Clinical Epidemiology
Undergraduate education
Medical School (see also ‘Graduate education’)
Bachelor Biomedical Sciences
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
30 Julius Center for Health Sciences and Primary Care
Medical school
Description
The medical curriculum is a continuous six-year educational program
without any distinction between the undergraduate and graduate phases.
In 1999 the curriculum was completely revised. The problem-based
learning method has been adopted (CRU’99) in this new curriculum. The
sixth year of CRU’99 began in 2004. All disciplines at the Julius Center
coordinate and/or participate in courses on the medical curriculum.
In addition, the SUMMA - School for Utrecht Medical Masters curriculum started in 2004. The aim of the program is that 40 bachelor
students obtain their MD degree in four years.
Course information
CRU ‘99 (course names in Dutch)
number of
students
year in
curriculum
discipline1
coordination /
participation
Oriëntatie geneeskunde
312
1st year
GP/PH
coordination/part.
Stofwisseling
312
1st year
DT
participation
Klinisch lijn onderwijs
312
1st year
GP
coordination
Patiënten volgprogramma
312
1st year
GP/NS
coordination/part.
Patiënten volgprogramma
312
2nd year
GP/NS
coordination/part.
Zintuigen, Hersenen en Beweging II
312
2nd year
GP
participation
Stofwisseling II
312
2nd year
GP
participation
Groei en ontwikkeling
312
2nd year
DT
participation
Acute Geneeskunde
312
3rd year
GP
coordination/part.
Architectuur klinisch wetenschappelijk onderzoek 288
3rd year
CE/GP
coordination/part.
Infectie en Afweer
312
3rd year
GP
participation
Keuzeblok gezondheidsrecht
75
3rd year
PH
coordination
Keuzeblok zorgmanagement
75
3rd year
PH
coordination
Keuzeblok medische ethiek
50
3rd year
PH
coordination/part.
Keuzeblok voeding: curatief of preventief
44
3rd year
DT
coordination
Introductiecursus CIBA PatientenZorg in
Nederland
16
3rd year
GP/PH
coordination/part
Leeronderzoek medische ethiek
15
4th year
PH
participation
Oogheelkunde
312
4th year
GP
participation
Annual Report 2005 31
CRU ‘99 (course names in Dutch)
number of
students
year in
curriculum
discipline1
coordination /
participation
Determinanten van ziekte
288
4th year
GP
participation
Geneeskunde en maatschappij
288
5th year
PH/GP
coordination/part.
Co-schap sociale geneeskunde
288
5th year
PH
coordination
Keuzeonderwijs ‘systematisch literatuuroverzicht’
7x
4th/5th year
CE
coordination
Co-schap huisartsgeneeskunde
288
5th year
GP
coordination
Onderwijs professionaliteit startblok &
terugkomdagen
100
6th year
PH
participation
Algemene Semi-Arts Stage (ASAS)
Huisartsgeneeskunde
20
6th year
GP
coordination
Startblok
165
6th year
CE/PH
coordination/part
Terugkomdagen
165
6th year
CE/PH
coordination/part
Wetenschapsstage
Variable
6th year
All
participation
SUMMA 2
number of
students
year in
curriculum
Discipline1
coordination /
participation
Praktijk van de zorg
40
1st year
GP
Coordination
Klinisch Denken 1
40
1st year
GP
Participation
Klinisch Denken 2
40
1st year
GP
Participation
Wetenschappelijke Vorming 2
40
2nd year
CE
Coordination
Co-schap huisartsgeneeskunde
40
3rd year
GP
Coordination
Disciplines: General Practice (GP), Clinical Epidemiology (CE), Nursing Science (NS), Nutritional Sciences, (Dietetics, DT), Public Health/
MTA/Medical Ethics (PH)
2
School for Utrecht Medical Masters
1
Output 2005
Number of students
See table above.
32 Julius Center for Health Sciences and Primary Care
Bachelor Biomedical sciences
Description
In the first year of the biomedical sciences bachelor program, staff
members of the interfaculty Institute of Risk Assessment Sciences
(IRAS) with joint posts at the Julius Center and the Faculty of
Veterinary Medicine, are responsible for the coordination of a six-week
course on epidemiology (Prof. D. Heederick, PhD, L. Portengen, PhD).
In addition staff members of the Julius Center participate in these
lectures (Prof. D.E. Grobbee, MD, PhD).
In the second year of the program, staff members participate in course
P3, an inductory course to the different masters’ programs student may
choose to enter after completion of their bachelor studies. (C.
Uiterwaal, MD, PhD).
In the third year, staf members organise and teach a ‘keuzecursus’
(optional course) Clinical Trials (I. van der Tweel (Julius Center and
UU Center for biostatistics) and P.A.H. van Noord, MD, PhD, Julius
Center).
Course information
BMS-bachelor (course names in Dutch)
number of
students
year in curriculum
discipline*
coordination /
participation
Epidemiologie
189
1st year
CE, EE
coordination
Project 3, Orientatie op de master programma’s
150
2nd year
CE
participation
Keuzecursus Clinical Trials
20
3rd year
CE, Biostat
coordination
* Discipline: Clinical Epidemiology (CE), Environmental Epidemiology (EE), Biostat (Center for biostatistics, Utrecht University
Output 2005
Number of students
See table above.
Annual Report 2005 33
MSc Biomedical Sciences, masterprogramme Epidemiology
Description
Initiated by the combined epidemiological research groups at UMC
Utrecht and Utrecht University (Julius Center, IRAS, veterinary
epidemiology, and pharmaco-epidemiology) a research masters’
program in epidemiology is organised. The programme started in
September 2004 with 15 students and the number of students has
doubled in 2005.
In 2005 a second variant of the programme started: in addition to the
2 year regular masterprogramme, a shorter 18 months postgraduate
programme was developed, which is open to MDs, VDs, PhD students
and other professionals at acdemical level. Coordination of the
program is by the Julius Center.
In December 2005 Utrecht University awarded the Epidemiology
master program with the exclusive Prestige Master label.
Specialisation possibilities within the epidemiology program are:
●
Clinical Epidemiology
●
●
●
●
Epidemiology of Infectious Diseases
Veterinary Epidemiology
Pharmaco-epidemiology
Environmental and Occupational Epidemiology
34 Julius Center for Health Sciences and Primary Care
Course information 2005 (only courses with participation of JC staff in
faculty)
BMS- research master program epidemiology
weeks
number of
students
discipline*
coordination /
participation
Advanced Diagnostic Research, 28 Feb-4 March 2005
1 wk
43
CE
coordination
Prognostic Research, 14-18 March 2005
1 wk
29
CE
coordination
Clinical Trials and Drug Risk Assessment, 18-22 April 2005
1 wk
29
CE
coordination
Introduction to Epidemiology, 5-16 Sep 2005
2 wk
45
CE
participation
Study Design, 19 Sep-7 Oct 2005
3 wk
55
CE
coordination
Clinical Epidemiology,
4 wk
56
CE
coordination
* Discipline: Clinical Epidemiology (CE)
Output 2005
Number of students
Start September 2005: 33 students:
Origin of the subscriptions:
●
UU BMS epidemiology, initial:
4 students
●
UU BMS epidemiology, postgraduate
20 students
●
UU BMS veterinary epidemiology and economics,
postgraduate:
9 students
Note: Courses are also attended by students from other masters’
programs and post-initial (Nihes) students, hence the larger number of
attendance in several courses (see table).
Annual Report 2005 35
MA Applied Ethics
Course information
Medical Ethics
number of
students
ects (weeks)
coordination/
participation
20
15 (10 weeks)
Coordination/part.
Output 2005
Number of students
See table above.
36 Julius Center for Health Sciences and Primary Care
MSc Nursing Science
Description
In 2000, a Dutch Master of Science degree for the Health Sciences
program was established at Utrecht University (UU). Nursing Science
was the first major field of study to be offered within the Health
Sciences program. 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 program was
necessary in order to comply with the European regulations for
university education and to conform with the international BachelorMaster structure in higher education. This resulted in the development
of two programs: a one year part-time premaster program (30 ects) for
graduates of a bachelor degree program in professional education with
a deficiency in academic skills, and a two year part-time master
program (60 ects) for graduates of a BSc-university degree program or
a premaster program (see table below). Both the premaster and master
Nursing Science UU programs started in September 2005.
The Department of Nursing Science within the Julius Center for Health
Sciences and Primary Care is responsible for the development and
coordination of the Nursing Science field of study.
Annual Report 2005 37
MSc Program information
Ects
Premaster Nursing Science
30
Project and Academic Skills
7.5
Philosophy, Science and Ethics
7.5
Research Methods
7.5
Statistics
7.5
Master Nursing Science
60
Strategic Management and Implementation
15
Science and Nursing Practice
15
Elective course
6
Research proposal
9
Master’s Thesis
15
For more detailed information (in Dutch) concerning the MSc program, check the website of the Department of Nursing Science:
http://www.umcutrecht.nl/afdeling/overzicht/overzicht.asp?dep=148&mmid=938
Output 2005
Number of students:
●
Started in 2005: 62 premaster students (UU) and 50 master students
(UU)
●
Graduated in 2005: 6 old Master MU1 and 13 old Master UU; 4
students graduated cum laude and 2 students graduated with honor
●
Total number of enrolled students: 217 dispersed over three
different academic programs new Premaster and Master program
UU (112); old Master UU (90) and old Master MU1 (15)
Other relevant information
●
The External Accreditation Committee (EAC) - a committee
appointed by the Ministry of Education and responsible for
accrediting all university programs – evaluated the new UU MSc
Nursing Science program in December 2005. The EAC’s verbal
report was very positive about all the improvements that they saw
38 Julius Center for Health Sciences and Primary Care
in the new MSc in comparison with their evaluation and
recommendations in October 2004 concerning the old MSc
program.
●
●
In September 2005, Mieke Grypdonck, PhD RN, Professor and
Chairperson of the Department of Nursing Science delivered the
annual Mebius Kramer Lecture entitled ‘Between Nursing and
Nursing Science’. This lecture marked the start of her retirement
after 10 years as Professor of Nursing Science at Utrecht University.
During the Mebius Kramer Lecture Ceremony, Professor
Grypdonck was awarded a Dutch Royal Medal of Honor in
recognition of her contribution to the field of Nursing Science.
In addition to the academic program, the Department of Nursing
Science provides continuing education courses to the nursing
community. The second annual course (18 hours) in Reading and
Evaluating Nursing Research was offered to 9 participants in the
spring of 2005.
Annual Report 2005 39
General practice vocational training
Description
The Julius Center is home to one of the eight General Practice
Vocational Training Courses in the Netherlands. This admits 72 junior
doctors a year. It is a three-year course and consists of two years of
training in general practices 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 206 general practitioners, 5 peripheral
hospitals, 22 nursing homes and 19 regional institutes for outpatient
mental health care. The trainees attend the department of general
practice for reflection and training one day a week.
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
practice. In the second year, particular attention is paid to the
cooperation between the GP, specialist, Regional Institute for
Outpatient Health Care and the nursing home. 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.
Output 2005
Number of students
In only a few years the capacity has been increased from 72 to 206
trainees in 2004.
●
Number of students who finished their GP training in 2005: 59
●
Number of students who started their GP training in 2005: 72
40 Julius Center for Health Sciences and Primary Care
Other relevant information 20051
4 course organizers and 28 trainers started work in our department in
2005.
In 2005 the Capacity of the Department of General Practice Vocational
Training has increased. Therefore we have hired new staff.
1
For more information see also www.juliuscenter.nl/huisartsopleiding or
‘Jaarverslag 2005 van de Huisartsopleiding Universitair Medisch Centrum
Utrecht’.
Annual Report 2005 41
Graduate schools UGS Life Sciences, Nihes, ImagO,
Eijkman and P&H
Description
In 2005 Utrecht University launched six Utrecht Graduate Schools in
which all research master programmes and PhD-trajectories are
combined, clustered according to theme. All PhD students of the Julius
Center are part of the Utrecht Graduate School (UGS) Life Sciences.
The effects of this clustering will become more apparent in the next
years, one of the first changes being the start of new doctoral degree
regulations in February 2006.
In addition to being part of the UGS life sciences, the Julius Center is
involved in four KNAW-graduate schools, formally accredited as such
by the Royal Netherlands Academy of Science (KNAW). This means
that staff members and PhD students participate in the research and
educational programs of these schools. Participation in more than one
KNAW-school is common, depending on the subject and
methodological setup of someone’s research. Three of these schools
have their chair in Utrecht: the Graduate School for Biomedical
Imaging (ImagO), the Eijkman Graduate School for Infection and
Immunity (Eijkman), and the Graduate School for Psychology &
Health (P&H). One has its chair in Rotterdam: the Netherlands
Institute for Health Sciences (Nihes). At each of Nihes, ImagO and
Eijkman members of the Julius Center’s staff are responsible for part of
the courses. For Nihes Prof. D.E. Grobbee is programme director
Clinical Epidemiology and member of the board.
Course information
The policy is that all internal PhD students at the Julius Center attend
to a formal educational programme, either the UU postgraduate MSc
42 Julius Center for Health Sciences and Primary Care
programme epidemiology (started Sep 2005, as from that moment this
is the preferred educational programme for the internal PhD Students)
or the educational program of one of the above-mentioned graduate
schools. In rare cases PhD students only attend part of a program, e.g.
in some cases this involves part-time appointments. A combination of
individual courses is then selected and has to be approved by the
supervisors. In the cases that PhD students are part of more than one
KNAW graduate school, the educational programs of the schools can
usually be combined in such a way that courses taken at one school can
partly substitute for the course program at another school, enabling
students to attend two schools without having to double their effort.
This means that they can optimize their individual educational
programs.
Output 2005
Number of students
The 33 PhD-students (17 internal) who finished their thesis in 2005
attended the following schools:
Nihes:
16 students (10 internal, 6 external)
ImagO:
4 students (3 internal, 1 external)
Eijkman:
2 students (1 internal, 1 external)
P&H:
5 students (5 internal)
Other:
1 external student Graduate School of NeuroSciences
Note 1: PhD students may attend more than one graduate school.
Note 2: Data on external PhD students’ attendance may be incomplete.
Annual Report 2005 43
Table: attendance at graduate schools by PhD students (for Title,
University and Date of PhD defense, see “Publications 2005”)
X
Internal
X
Bergman, G.J.
External
X
Biesheuvel C.J.
Internal
X
Bijlsma, T.S.
External
Bootsma, M.C.
External
Brouha, X.D.R.
Internal
Brussee, J.E.
External
X
Cremer, O.L.
External
X
Dijk, J.M.
Internal
X
Dijk, K. van
External
X
Elvan-Taspinar, A.
External
Giovannangelo, M.E.C.A.
External
Hartog, J.J. de
External
Kamphuis, H.C.M.
Internal
Koek, H.L.
Internal
Koeman, M.
External
Kolk-Kousemaker, M.
Internal
Konijnenberg, A.Y.
External
X
Kuijpers, A.C.
External
X
Kwee, A.
External
Oosterheert, J.J.
External
Opstelten, W.
Internal
Oudega, R
Internal
Prinssen, M.
External
Ravelli, D.P.
Internal
Rinaldi, S.
Internal
X
Rutten, F.H.
Internal
X
Schrijver, E.L.L.M.
External
Störk, S.F.L.
Internal
X
Trijp, M.J.C.A.
Internal
X
Tromp, D.
Internal
X
Weijman, I.
Internal
X
44 Julius Center for Health Sciences and Primary Care
Other
Internal
Atsma, F.
P&H
Akkerman A.E.
Eijkman
Graduate school
ImagO
In/External
NIHES
Name
X
X
X
X
X
X
X
X
X
X
X
X
Advanced training in public health
Description
Post-academic training for health care professionals
Course information
In 2005 the Julius Centre organized 10 courses, covering 22 training
days in total, for health care professionals.
Course title
Number of students
Date
Health law
28
January-March 2005, 10 evenings
Netherlands Public Health Congress
750
April 13-14, 2005
Disease Management Programs
60
March-May 2005
Mental Health Care Programs
80
June 21, 2005
Master class Quality Indicators and Management Control
12
August-December 2005
Acute Care Organization
250
September 9, 2005
Occupational Health Care and Primary Health Care
75
November 3, 2005
European Health Executive Program
10
October 25-28, 2005
Access to Long term Care
180
December 2, 2005
Needs Assessment and Innovations in Youth Health Care
150
December 9, 2005
Output 2005
Number of students
See table above.
Annual Report 2005 45
Advanced training in general practice
PAOH
Description
Post-academic training for general practitioners (Post Academisch
Onderwijs voor Huisartsen, PAOH-Utrecht). The focus is on up-todate information for GPs, evidence based and relevant to general
practice.
Course title (Dutch)
Voeding
KNO & Oogheelkunde
Diagnostiek
Astma en COPD
Mannen en vrouwen
Dermatologie
Maag-darm-leverziekten
8ste Diabetesdag
Speciale patiëntengroepen
PAO-H EXTRA Beslissingen rond levenseinde
PAO-H EXTRA Acute geneeskunde
Course information
In 2005 the Julius Center organized 9 days (6 points) and 2 afternoons
(PAOH EXTRA, 3 points) for GPs in the Netherlands.
Output 2005
80-200 GPs attended each course (with a total of 1285 GPs)
46 Julius Center for Health Sciences and Primary Care
Training-course for executives in diabetology in primary care
Description
A 2-year course in diabetology, intended for general practitioners who
want to become an expert in diabetology in primary care. Two hundred
hours will be spent on several scientific and clinical aspects of
diabetology as well as on teaching in diabetology. Self-study, lectures
and training periods form part of the course. Negotiating skills will
also be trained.
Course information
The course is organised under the auspices of the Julius Centre, in
collaboration with the Dutch College of General Practitioners with its
Expert Group on Diabetology (DiHAG) and the Departments of
General Practice of the Radboud Medical Centre Nijmegen and the
Free University Medical Centre.
Output 2005
In December 2005 20 GPs from all parts of the country started the
course.
Annual Report 2005 47
Advanced training in clinical epidemiology
Description
Post-academic training for health care professionals, medical
specialists, and (senior) clinical researchers.
Course information
In 2004 the Julius Center organized a course on Evidence Based
Medicine aimed at health care specialists and senior clinical
researchers. A series of debates was also started at the University
Medical Center Utrecht to focus the attention on and promote a
critical attitude towards Evidence Based Medicine.
Course title (Dutch)
Number of
attendants
Date
6th Julius Course, Evidence Based Medicine
19
20-22 May 2005, 3 days
Debates in Evidence Based Medicine
‘De polypil voor iedereen!’
‘De acute buik: de subjectieve hand of het objectieve beeld?’
150*
150*
05 Oct 04
14 Dec 04
*Approximate number attending each debate
Output 2003
Number of students/attendants
See table above.
48 Julius Center for Health Sciences and Primary Care
Patient care
Nutritional sciences and dietetics
Nutrional sciences and Dietetics form one section. Eduction and research
are the core activities of Nutritional Sciences, as can be found elsewhere
in this report. Patient care provided to UMC Utrecht and rehabilitation
center ‘De Hoogstraat’ is the core activity of the Dietetics section.
Evidence based guidelines
One of the most important goals of the section, development of
evidence-based guidelines, has made progress. Two out of 12 guidelines
have been completed in 2005. Moreover, a great number of product
descriptions (short practical guidelines) have been completed in 2005
(21 completed and 31 ongoing). We also evaluated the evidence-based
process that was started in 2001, and concluded that it has contributed
to a more structured and academic way of thinking and working
among the dieticians. Training was provided to our dieticians in the
form of external courses, meetings, and conferences (50 activities in
total, 2 per dietician) mostly in the Netherlands, but also in other
European places.
External (international, national and regional) projects
The Dietetics section contributed to several external projects. The most
important are:
●
involvement in the CBO guidelines ‘Peri-operative nutrition’ and
‘Cystic Fibrosis’
●
coordination of the national project ‘Ketogenic nutrition guidelines’,
including evidence-based guidelines and the development and
implementation of a patient database
●
contribution to the development of ‘National Vietnamese Nutrition
Annual Report 2005 49
●
Guidelines’. This latter project stressed some of the universal aspects
of dietary guidelines.
initiation of a regional oncology group
contribution to the development of a regional policy plan for
outpatient care
●
development and national introduction of a novel method to advice
phenylketonuria (PKU) patients.
Besides these projects, our staff participated in a wide range of
(national) consultation groups.
●
Internal projects
Within the UMC-Utrecht, the Dietetics sections participated in the
following internal projects and working groups:
●
hosting the UMC Utrecht Clinical Nutrition Advice Board, which
enables us to discuss nutrition problems and new insights in
dietetics in a broader clinical context
●
development and launch of Dietetics website. At this moment the
site is only accessible for UMC Utrecht co-workers, but it will be
available for patients in the future. The site was launched during a
●
●
●
●
UMC Utrecht life-style event organized by the section and the
UMC Utrecht medical service.
participation in hospital food distribution project
repositioning dietetics in the food allergy team
positioning dietetics in the new ICU ward
assistance in clinical multicenter studies (Masterplan, Propatria)
Educational and scientific contributions
Several lectures and workshops have been presented to other
professionals, on topics such as Cystic Fibrosis, heart failure, and
evidence-based nutrition.
50 Julius Center for Health Sciences and Primary Care
We evaluated the contribution of student projects to our Dietetics
section. We decided that more effort should be given to a) publication
of results (as posters, oral presentations and scientific papers) and to b)
implementation of the findings in dietary guidelines
Chapters for several books were written, which will most likely be
published in 2006.
Personnel
In 2005 4 dietitians left the UMCU due to retirement (1), change of
specialization (2) and a job closer to the their place of residence (1).
The vacancies were filled with 3 new dieticians and several changes in
the allocation of dieticians over the various divisions in the hospital
had to be made. The co-operation with rehabilitation center ‘De
Hoogstraat’ was evaluated.
Care provided by the Dietetics section in 2005
1st visit
Follow-up visits
DME*
Outpatients
776
3485
4803
Hospitalized
726
1909
3228
No show
115
329
Outpatients
654
2361
2999
Hospitalized
1515
5262
6814
Outpatients
668
3066
5013
Hospitalized
401
989
2089
No show
9
32
Rehabilitation centre Hoogstraat
201
482
Team 1
Team 2
No show
Team 3
695
DME *= 30-minute time units
Annual Report 2005 51
Julius Center Health Care Leidsche Rijn
Since January 2004 the Julius Center has been hosting a network for
academic patient care, located in a newly developed area of Utrecht,
“Leidsche Rijn”. In the next few years Leidsche Rijn will expand to a
large suburban area, with approximately 80,000 inhabitants. Health
care services in it will be provided from 6 health centers, which will
offer integrated services: general practice, physiotherapy, mental health
care, mother and child health services, pharmacy and social workers. In
the underlying health care concept for Leidsche Rijn these curative
services are closely related to preventive, social and educational
activities in the area.
This concept is being worked out in close cooperation with municipal
health authorities, the University Medical Center, the MESOS hospital
and the regional general practitioners’ organization. The new MESOS
hospital will be built in the center of Leidsche Rijn, offering excellent
opportunities for continuity of care and cooperation between general
practitioners and consultants (secondary care specialists).
In 2005 three health centers were operational: Parkwijk, offering health
care services for 9,500 inhabitants, Veldhuizen, with 7,500 listed
patients and rapidly expanding Terwijde with 2,100 listed people at the
end of 2005. The centers offer primary medical care (14 general
practitioners, 9 full time equivalent), physiotherapy (9 physiotherapists,
approximately 6 fte), and additional dietary services, obstetrics, social
work, farmacy etc. The medical services cover the full spectrum of
family medicine, with curative care, chronic disease management for
hypertension, diabetes and lung disease (through practice assistants
and practice nurses) and preventive services. Management in the health
centers is directed by the Julius Center.
52 Julius Center for Health Sciences and Primary Care
A new health center was developed for the Vleuterweide district, which
will become operational in the coming 3 years. It will open in March
2006. The next few years two more centers will be developed for
‘t Zand and the Central Zone of Leidsche Rijn. Meanwhile health care
services for new inhabitants in those areas are provided from the
existing health centers nearby.
The Leidsche Rijn Network offers an excellent opportunity to the
Julius Center to fulfill its ambition of providing academic health care
services in primary care: high quality patient care, closely integrated
with (vocational) training and research. In order to facilitate this,
training facilities will be incorporated in the health centers at Leidsche
Rijn, enabling on-the-spot training of medical students, general
practitioners 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 an instant medical
assessment. In future this health profile will be related to actual
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 multidisciplinairy patientcentered health care programs.
Annual Report 2005 53
Business and operations
Operational support
The core activities of the Julius Center, research, education and patient
care, are supported by a number of services. Management is supported
by a central finance and a personnel & organization (P&O)
department. The finance department handles all contracts and other
financial matters. The P&O department deals with management
development, vacancies and all procedural matters involving
employment.
Project management and VIC
Project management involves the organization, monitoring and
conduct of patient-related studies. These may be small studies with less
than 20 patients, but also very large ones, including several thousands
of patients from different centers and countries. Expertise in the
measurement of vascular parameters (as collected in patient-related
studies) is bundled in the vascular imaging center. Expertise in data
collection and data management is concentrated in the data
management department.
Data management
Data Management provides a technical infrastructure for the collection,
processing and analysis of epidemiological data. The department
provides these services for the research conducted by the Julius Center,
but also for other divisions of the UMC Utrecht as well as external
parties. An overview of the projects can be found in the chapter
’Research Projects 2005’.
54 Julius Center for Health Sciences and Primary Care
In 2004 Data Management and Research Services developed a Quality
Assurance System in cooperation with KEMA. Both departments were
certified in January 2005 (ISO 9001:2000).
This year, Data Management participated in about 70 studies, of which
30 were carried out in cooperation with Research Services. These
include 20 new studies and eight cohorts (relating to mental health
care, oncology and general practice).
In 2003 the department began to provide services via the Internet. This
year electronic randomization and data capture have been used
successfully in several studies, six of which are fully web based.
The Data Management Department consists of 12.9 FTEs (15 staff in
absolute numbers).
ICT
The ICT Department is responsible for the development and
maintenance of an infrastructure that supports both office automation
and the scientific research carried out by the Julius Center. It provides
user support and Internet development services.
The department was certified by KEMA (ISO 9001:2000) in January
2005.
The ICT Department consists of 4.7 FTEs (5 staff in absolute
numbers).
Annual Report 2005 55
Personnel and finances
Personnel, figures (2005-12-31)
Absolute numbers
Scientific
Support
Care
Total
Male
72
29
1
102
Female
110
82
31
223
Total
182
111
32
325
FTE
Scientific
Support
Care
Total
Male
42.73
25.62
0.68
69.03
Female
71.74
58.27
22.60
152.61
Total
114.46
83,90
23.28
221.64
Average FTE
Scientific
Support
Care
Male
0.59
0.88
0.68
Female
0.65
0.71
0.73
56 Julius Center for Health Sciences and Primary Care
Personnel, listing 2005
Clinical epidemiology
Professors
Schouw, Y.T. van der, PhD
Prof. Algra, A., MD, PhD
Soedamah-Muthu S.S., MD, PhD
Prof. Bonten, M.J.M., MD, PhD
Stolk, R.P., MD, PhD
Prof. Brunekreef, B., PhD
Uiterwaal, C.S.P.M., MD, PhD
Prof. Graaf, Y. van der, MD, PhD
Vergouwe, Y., MD, PhD
Prof. Heederik, D., PhD (adjunct faculty)
Junior staff
Prof. Hoes, A.W., MD, PhD (also GP)
A, D.L. van der, MSc
Prof. Grobbee, D.E., MD, PhD
Ariesen, M.J., MSc
Prof. Moons, K.G.M., MD, PhD
Asselt, K.M. van, MD
Prof. Neeleman, J., MD, PhD
Atsma, F., MSc
Prof. Rheeder, P., MD, PhD (Adjunct
Biesheuvel, C.J., MSc
faculty)
Brouwer, B.G., MD
Brussee, J.E., MSc
Coordinating staff
Buchner, F.L., MD
Kluijtmans, M., PhD
Dijk, J.M., MD
Duijnhoven, F.J.B. van, MSc
Senior staff
Elias, S.G., MD
Bots, M.L., MD, PhD
Fonds, D., MD
Burger, H., MD, PhD
Giele, J.L.P., MD
Geerlings, M.I., PhD
Goessens, B.M.B., MSc
Gils, C.H. van, PhD
Janssen, K.J.M., MSc
Heijden, G.J.M.G. van der, PhD
Kamphuis, M.H., MSc
Monninkhof, E.M., MD, PhD
Klein, W.M., MD
Noord, P.A.H. van, MD, PhD
Knol, M.J., MSc
Peeters, P.H.M., MD, PhD
Koek, H.L., MD
Portengen, L., MD (Associated)
Koerselman, J., MD
Annual Report 2005 57
Kok, H.S., MD
Coordinating staff
Koopman, L., MSc
Appelman, C.L.M., MD, PhD
Laan, W., MSc
Pieters, H.M., MD, PhD
Maas, A.J.B.M., MD
Molenaar, E.A., MSc
Senior staff
Muis, M.J., MD
Albert, M.C.G.A., MSc
Onland - Moret, N.C., MSc
Balen, F.A.M. van, MD, PhD
Raamt, A.F. van, MD
Banus, G.E.G.M., MD
Ramadhani, M.K., MD (adjunct
Barels, I.H., MD
faculty)
Bartelink, M.E.L., MD, PhD
Straatman, M.N., MSc
Batenburg, V., PhD
Trijp, M.J.C.A. van, MD
Beek, C. van, MD
Verheus, M., MSc.
Belgraver, A., MD
Wezep, M.J. van, MSc
Berkestijn, L.G.M. van, MD, PhD
Boer, L.J. de, MD, PhD
Support
Bonten, M.J.M., MD, PhD
Batenburg, T.A.J. van
Bosman, M., MSc
Broeders, C.A.E., MSc
Brink, J.C. van den, MSc
Haks – Schoonderwoerd, T.L.T.M.
Brinkman, H.J.W.
Kole – de Jong, S.
Bruggen, E. van, MSc
Kiersch, N.
Carels, H.M.
Meegdes - Kuiperij, H.
Cozijnsen, M., MD
Vries, G. de
Dagnelie, C.F., MD, PhD
Zanten - Nout, A. van
Dudok van Heel-Sakkers, P.M.A.,
MSc
General practice
Professors
Eenige, M.M. van, MD
Prof. Hoes, A.W., MD, PhD (also CE)
Feijen, M.K.E., MD
Prof. Rutten, G.E.H.M., MD, PhD
Filippo, M.E.D., MD
Prof. Verheij, Th.J.M., MD, PhD
Geijer, R.M.M., MD
Essen, G.A. van, MD, PhD
58 Julius Center for Health Sciences and Primary Care
Gorter, K.J., MD, PhD
Schouten, M., MSc
Graaf, A.P. de, MD
Smulders, M.M.Th., MD
Groot, M. de, MSc
Stempvoort, W.M. van, MD
Grunt, N.G. de, MD
Tiesema, M., MSc
Hak, E., PhD
Truijens, L., MD
Hemert, M.M.H.M. van, MD
Vermeulen, M.I., MD
Hendrickx, E.F.H.M., MD
Wisselo-Peek, H.J.
Hirsch, R., MD
Wit, N.J. de, MD, PhD
Hörchner, C.D., MD
Zwart, D.L.M., MD
Jacobs, V.E.J., MD
Zwart, S., MD, PhD
Jong, H.H.G. de, MD
Konings, J.E., MD
Junior staff
Kruithof, P.J., MSc
Akkerman, A.E., MD
Kuyvenhoven, M.M., PhD
Avendonk, M.J.P. van, MSc
Kwee, S.K., MSc
Beunder, M.. MSc
Leeuwen, A.J. van, MSc
Bont, J., MD
Maaijen, J., MD
Bruggen, J.A.R. van, MD
Manschot, P.B.J.T., MD
Cleveringa, F.G.W., MD
Mathot, A.M., MD
Kelder, J.C., MD
Mol, S.S.L., MD, PhD
Muller, L.M.A.J., MSc
Numans, M.E., MD, PhD
Scheltens, T., MD
Opstelten, W., MD, PhD
Schönbeck, Y., MSc
Oudega, R. MD, PhD
Staaij, B.K. van, MD
Quartero, A.O., MD, PhD
Velden, A.W. van der, MSc
Raat, A.M.C., MD
Rijken, M.E., MSc
Support
Rovers, M.M., PhD
Blijleven, E.M.
Rutten, F.H., MD, PhD
Bogaards-Godschalk, M.
Sachs, A.P.E., MD, PhD
Hartog, M.A. den
Scheele, E.A.E., MD, MSc
Hoeven - van Vriesland, I.A. v den
Annual Report 2005 59
Honk, S.M. van
Hageman - Raatgever, G.M.C.
Knape - van Santen, M.
Linde, M.L. van der
Laurens, I.C.
Straaten, M.C. van
Mertens, W.
Simon, P.
MTA
Professors
Velthof, C.G.M.
Prof. Hout, B.A. van, PhD
Wolf - Verschuure, T.W.P.M.
Prof. Van Delden, J.J.M., MD, PhD
Public health
Professors
Senior staff
Prof. Schrijvers, A.J.P., PhD
Buskens, E., MD, PhD
Prince - Thissen, C.J.M.
Bonneux, L.G.A., MD, PhD
Maillé, A.R., PhD
Senior staff
Stel, H.F. van, PhD
Baar, van M.E., PhD
Kwee, S.K., MA
Junior Staff
Weert-v Oene, G.H. de, MPH, PhD
Janssen, M.P., MSc
Zaadstra, B.M., MD, PhD
Koffijberg, H., MSc
Stuifbergen, M.C., MSc
Junior staff
Verschuuren, M., MSc
Bie – de Waal, M.N.A. de, MSc
Vries, A. de, MSc
Meier, M., MSc
Zutphen, P.G.C.M., MSc
Niesink, A., MSc
O, Y.L., MD, PhD
Support
Raijmakers, V.J.A., MSc
Bruin, C.E.T. de
Simkens, A.B.M., MSc
Villevoye, D.P.J., MSc
Nursing science
Professors
Support
Prof. Grypdonck, M.H.F., PhD
Dijken, G.D. van
Prof. Shortridge - Baggett, L., PhD
60 Julius Center for Health Sciences and Primary Care
(adjunct faculty)
Talens, S., MSc
Prof. Duijnstee, M.S.H., PhD
Tromp, D.M., MSc
(adjunct faculty)
Vree, W. de, MSc
Weldam, S.W.M., MSc
Coordinating staff
Bijl, J.J. van der, PhD
Support
Meijel, B.K.G. van, PhD
Dekker, M.M.
El Bouasati, S.
Senior staff
Martin, A.F
Engel, M., MSc
Vonk, N.M.S.
Gamel, C.J., PhD
Wijbenga, J..
Leeuw, J.R.J. de, PhD
Ros, W.J.G, PhD
Nutritional sciences/dietetics
Professors
Schuurmans, M.J., PhD
Prof. Staveren, W.A. van, PhD
Linge, R.H. van, PhD
Vliet, M.J. van, PhD
Coordinating staff
Junior staff
Bruin, M. de
Goverde, C.A.M., MSc
Runia, S.
Groot – May, A.M. de, MSc
Huitema, M.C., MSc
Senior staff
Hooft - Leemans, G. van der, MSc
Roos, N.M. de, PhD
Horenberg, A.H., MSc
Kars, M.C., MSc
Junior staff
Kruk – Kamstra, T.F. van der, MSc
Iestra, J.A.
Megens, Y.A.C.T., MSc
Moes, H., MSc
Dietetics
Oirschot – v.d. Ven, M.M.M., MSc
Achterberg, M.D.
Oosterom, M., MSc
Carbasius Weber, E.C.
Swieten - Duyfjes, E. van, MSc
Doorn, G.M. van
Annual Report 2005 61
Harten, J.N.N. van
Management support
Coordinating staff
Hazendonk, J.F.M. van
Starre, M. van der, MSc
Fabels, B.M.
Heest - Cooman, P.D. van
Hiemstra, G.K.
Administrative staff
Hollander - Kraaijeveld, F.M.
Bekkers, M.H., MSc
Hurk, Th.A.M. van den
Boerlage, P.A.
Janse, L.C.M.
Booden, K., BSc
Jonge - Wierda, J.I. de
Dettingmeier, R.D. (external)
Jongh - Kampherbeek, E.H. de
Groot, de E., MSc
Kemp, K.
Horstink, G.H.M.
Leermakers - Vermeer, J.M.P.
Kok - Kortekaas, M.G.A.
Los, M.
Kolste, L.J.C.
Luyt, J.W.H. van der
Plomp, E.P.
Michelsen - Huisman, A.D.
Pijl, A.G.
Renken - Terhaerdt, J.W.M.
Veen, R.E.R., MSc
chreurs, J.C.M.
Wees - Ester, P.A. van
Schuit, L.E. van der
Somer, M.
Personnel and organization
Steenhagen, E.
Brasser, S. (external)
Stijvers - de Leeuwerk, W.E.
Molenaar, J.J.
Timmer, C.
Nimwegen, M. van
Wamsteker, E.W.
Rietveld, M.A. (external)
Woestenenk, J.W.
Rookhuijzen, I.M. van
Winkel, A.J.
Support
Gil, A.
Support
Maarseveen-Hendriks, J.M.
Putman-Schuurmans, M.G.
Riele, ter, M.A., MSc
Riet, M.F. van ‘t
62 Julius Center for Health Sciences and Primary Care
I&A
Jong, S.E.C.A. de, M.D.
Bouabdellaoui –Abahai, S.
Kaptein - Waterink, J.H.
Dieleman, K.P.
Leeuw, M. de, MSc
Harkema, J.C.
Meer - Poelwijk, M.J. van der
Nelissen, R.
Meijer, R.
Zwaan, G.W. de
Meijers, G.E.P.M.
Metselaar - van den Bos, J.J.
Research support
Coordinating staff
Moes – van der Vlist, L.
Bak, A.A.A., MD, PhD
Nijssen, K.M.
Veen, R.E.R., MSc
Nollen, C.Th.M.
Mooiweer - Boogaerdt, D.B.
Noordzij- van Willligen, J.J.
Project management and Vascular
Imaging Center
Plantinga, M.
Bakker, L.T.
Ram, E.A.M.
Bobbink, W.G., MSc
Bos, A.M.
Brink, J.J. van de, MSc
Rutgers, A.F.
Brugman, C.C.W., MSc
Scholten, M.J.G.
Drijvers, J.J.M.M.
Sikking, I.E.M.
Eck, J.W.M. van, MD
Slotboom, B.
Edlinger, M., MSc
Sonsma, A.C.M.
Everdingen, C.H. van
Sukel – Helleman, M.
Geurtsen – Ravenzwaaij, M. van
Suiker, A.M.H., MSc
Haars, G., MSc
Vendrig, L.
Hafkamp, M.C.
Verheij, F.A.
Hemert, G.B. van
Vliet - Boerkamp, B.B.M. van der
Hijman, L.E.M.
Vlist, B. van der
Hoorn - van Kempen, M.H. v der
Wijnia - Lemstra, E.A., MSc
Huizenga, T.J., MSc
Wilken, R.C.M.
Izeboud, L.D.
Williamson, K.
Prins, C.
Annual Report 2005 63
Wisse, H.
Petersen, R.B. van
Zwart, L.M.
Slotboom, B.J.
Spithoven - van Leeuwen, E.H.J.
Data management
Zuithoff, N.P.A, MSc
Boekema - Bakker, N., MSc
Support
Breeijen, J.H. den, MSc
Bogaards, E.E.
Geerts, A.C., MSc
Gaalman, K.M.
Gloudemans, E.A.H.L.
Heerik, F. van den
Gouw, A.P. van der
Koppenol, K.B.
Haak - van Mourik, M.L. van den
Linnebank – Hillebrand, N.
Heuveling, L.M.
Maekelbergh, C.E.
Huisinga, P.
Munnik, J.J. de
Leus, F.
Tims – Polderman, C.A.J.
Lom, R. van
Weel – van der Heijden, A.A.H.
Maaskant, J.W.
64 Julius Center for Health Sciences and Primary Care
Financial report
Financial overview 2005
K€
Personnel costs
k€
13,331
k€
Income
k€
15,946
UMC
9,373
UMC Utrecht
5,146
Projects
3,958
GPVT
3,000
Other
7,800
Investments
100
Computers
Running costs
100
2106
Travel & Lodging
338
Post & Phone
233
Office
694
Other
844
UMC Overhead
409
Total
15,946
Total
15,946
Annual Report 2005 65
Organizations and companies providing funding
AGIS Zorgverzekeringen nv
Ministerie van Volksgezondheid
Agricultural University Wageningen
Welzijn en Sport
Akzo Nobel N.V.
Nederlandse Hartstichting
Astmafonds
Nederlandse Organisatie voor
Astra Zeneca
Wetenschappelijk onderzoek
Altana Pharma BV
(ZonMW)
Aventis Pharma
Nederlandse Vaccin Instituut
Bayer HealthCare
Novartis Pharma BV
Bowling Pfizer
Novo Nordisk Farma bv
Centrum Maliebaan
Nutricia
College van Zorgverzekeraars
Organon nederland bv
Diabetes Fonds
Pfizer bv
Districts Huisartsen Vereniging
Pharmanet
Eli-Lilly bv
SBOH
European Union
Servier
Fonds OGZ
Shering Plough
Gemeente Amsterdam
Sticares
George Institute for International
Stichting centraal fonds Reserves
Health
Voormalig Vrijwillige
GlaxoSmithKline
Ziekenfondsverzekering
Internationale Stichting Alzheimer
Stichting Ergris
Onderzoek
Stichting instituut GAK
Koningin Wilhelminafonds
Stichting Interactie
(Nederlandse Kankerbestrijding)
Stichting Koningsheide
Landelijk Centrum Verpleging &
Stichting RIPAG
Verzorging
Stichting Vascular Research
Landelijke Stichting Beheer
Stichting Vecozo
Kruiswerk
Stichting VRN
66 Julius Center for Health Sciences and Primary Care
Stichting tot steun VCVGZ
University of Durham
Strangeways Research
University of Oxford
The Icelandic Heart Association
VU Medical Centre
The Stanley Medical Research
World Cancer Research Fund
Institute
World Health Organization
TNO-voeding
Zorgonderzoek Nederland
UMC Utrecht
Zorggroep Almere
Annual Report 2005 67
Research projects (2005)
Cardiovascular diseases
PhD projects, finished 2005
Name
Title
JC
Discipl
Atsma, F.
Reproductive factors and cardiovascular disease risk in postmenopausal
women
intern
CE, GP
Dijk, J.M.
Is new always better? Vascular risk factors in patients with manifest
arterial disease
intern
CE
Dijk, K.
Explaining variation in bleeding pattern of severe haemophilia
extern
CE
Elvan-Taspinar, A.
Central hemodynamics in pregnancy
extern
CE
Hartog, J.J. de
Cardiorespiratory effect of fine and ultrafine ambient particles.
extern
CE
Kamphuis, H.C.M. (*see In Rhythm. The impact of an ICD on quality of life.
also Mental Health)
intern
NS
Koek, H.L.
Acute myocardial infarction: linkage of national registers.
intern
CE
Oudega, R. (*see also
Methodology)
Diagnosing deep venous thrombosis in primary care
intern
GP
Prinssen, M.
Dream. Dutch Randomised Endovascular Aneurysm Management Trial.
extern
CE
Rutten, F.H.
Heart failure in COPD
intern
CE, GP
Schrijver, E.L.L.M. de
Secondary prevention of stroke. The rationale of antithrombotic
treatment.
extern
CE
Störk, S.F.J.
Endocrine and inflammatory markers, atherosclerosis and cardiovascular
risk
joined
CE
Trijp, M.J.C.A. van
Augmentation index, an indicator of cardiovascular risk?
intern
CE
Weijman, I. (*see also
Mental Health)
Diabetes at work. Fatigue in relation to job characteristics, diabetes
symptoms and self-management
intern
GP, NS
Name
Title
JC
Discipl
Appelman, A.P.A.
Early cerebral damage in patients with manifest vascular disease
intern
CE
Avendonk, M.J.P. van
DIASULIN: Insulin therapy in diabetes type 2 patients in general practice
intern
GP
Beelen, R.M.J.
Long-term effects of trafic-related air pollution on respiratory and
cardiovascular mortality.
extern
CE
Boonman, L.
Heart failure in diabetes
extern
GP
Bozkurt, O. (*see also
Mental Health)
UDES project pharmacy
joined
CE
Brouwer, B.G.
Evaluation of multidisciplinary care in cardiovascular disease
intern
CE
Bruggen, J.A.R. van
IMPETUS: Implementation and evaluation of shared care guidelines for
people with type 2 diabetes
intern
GP
Bruggink, P.
Value of doctor- and nurse directed multidisciplinary interventions in
heart failure
extern
CE, GP
Cleveringa, F.G.W.
Implementation of a soft-ware mediated diabetes care protocol in
general practice
intern
CE, GP
PhD projects, ongoing
68 Julius Center for Health Sciences and Primary Care
Cohen, D. (*see also
Mental Health)
Diabetes mellitus in schizophrenia or schizoaffective disorder: an
iatrogenic or endogenic problem?
extern
CE
Dogan, S.
Carotid intima media thickness: methodological aspects and clinical
relevance
intern
CE
Eck, J.W.M. van (*see
also Methodology)
Complications in first year after pacemaker implants
intern
CE
El Fakiri, F.
Preventive cardiovascular care in deprived neighbourhoods
extern
GP
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
Goessens, B.M.B.
Screening for second manifestations of atherosclerotic disease: impact
on patient management and cardiovascular risk
intern
CE, MTA
Gorter, P.
Epicardial fat and the metabolite syndrome in patients with high
cardiovascular risk
extern
CE
Halkes, P.H.A.
Minor and major vascular diseases of the brain
extern
CE
Hogenhuis, J.
Value and limitations of BNP and NT-proBNP in the clinical practice of
heart failure.
extern
CE
Jager – Geurts, M.H.
CVA incidence, prevalence and prognosis
intern
CE
Janssen, K.J.M. (*see
also Methodology)
Diagnostic and prognostic prediction rules: innovative methods to
improve their applicability - PhD project
intern
CE
Janssen, P.G.H.
The Dutch ADDITION Study; As part of the Anglo-Danish-Dutch study of
intensive treatment in people with screen detected diabetes in primary
care (ADDITION-studie)
intern
CE, GP
Jong, S.E.C.A. de
(DREAM)on: Dutch Randomised Endovascular Aneurysm Management
Trial - 2nd part.
extern
CE
Kamphuis, M.H. (*see
also Mental Health)
Depression and cardiovascular disease: the role of nutrition
intern
CE
Kelder, J.C.
Diagnostic strategies in patients suspected of heart failure
intern
CE, GP
Knol, M.J. (*see also
Mental Health)
Psychiatric comorbidity in diabetes (UDES-project JC)
joined
CE
Koffijberg, H.
Cost effectiveness analysis in aneurysm screening after surgical
treatment for ruptured aneurysms
intern
MTA
Kruif, I.L. de
Prevention of cardiovascular disease
intern
MTA
Laar, F. van de
Nutritional and pharmaceutical treatment aspects in newly diagnosed
type 2 diabetes patients in general practice
extern
GP
Lebrun, C.E.I.
The role of oestrogens in frailty in elder women: optimising the
indication for prevention therapy
extern
CE
Maas, A.H.E.M.
Cardiovasular risk profile during routine breast cancer screening: an
innovative approach of improved case-finding
intern
CE
Maessen, M.
Determinants of end-of-life decisions in ALS: prospective study
extern
CE
Meijs, M.F.L.
Non invasive cardiac imaging
joined
CE
Muller, L.M.A.J. (*see
also Infectious
Diseases)
Diabetes and infections, Education learning in program for Health
Improvement (DELPHI)
intern
GP, NS
Annual Report 2005 69
Nakhai Pour, H.R.
Effects of testosterone suppl. on functional mobility, quality of life, body
composition, cognitive function, vasc. ageing, and bone mineral density
in testosterone deficient men, PhDproject2
intern
CE
Oudejans, I.
Heart failure in the very old
extern
CE
Pruissen, M.
Genetic determinants for new vascular events in patients with cerebral
ischaemia
extern
CE
Raamt, A.F. van
Brain damage in patients with manifest arterial disease
intern
CE
Ramadhani, M.K.
Pathological left handedness revisited: origins and later life health
outcomes
intern
CE
Regieli, J.J.
Prognosis in ischemic heart disease. Impact and molecular determinants
of collateral circulation - the SMART study and REGRESS trial cohorts
joined
CE
Sabour, S.
Determinants of coronary calcification in healthy women
intern
CE
Scheltens, T.
Cardiovascular risk management in primary care
intern
CE, GP
Schuiling, W.J.
Extracerebral organ dysfunction and sleep disorders in subarachnoid
hemorrhage
extern
CE
Thoolen, B.
Beyond good intentions: Effectivenes of a behavioral intervention in
screen detected type 2 diabetes patients
extern
GP, NS
Toll, D.B. (*see also
Methodology)
Implementing a diagnostic algorithm to rule out deep venous
thrombosis in primary care
intern
CE, GP
Uijl, S. (*see also
Methodology)
Optimal diagnostic routing to determine the indication of surgery in
epilepsy patients
extern
CE
Vacature,
Facts and figures of cardiovascular diseases in the Netherlands,
continuation of first PhD project
intern
CE
Wermer, M.
Aneurysm Screening after surgical Treatment in Ruptured Aneurysms
(ASTRA)
extern
CE, MTA
Wijk, I. van
Life Long After Cerebral Ischaemia
extern
CE
Other projects, finished 2005
Name
Title
JC
Discipl
Brinkhuijsen, M.
Intensified target driven treatment of screendetected type 2 diabetes:
effects on nontraditional markers of the metabolic syndrome
intern
GP
Dalmeijer, G.
Intake of betaïn and choline and cardiovascular risk
intern
CE
Giele, J.L.P.
Vascular risk and early brain damage
intern
CE
Graaf, Y. van der
Follow-up Dutch BScc cohort
intern
CE
Kol, E.A.H.M.R. van
Validation and cost-effectiveness of a new pressure ulcer risk
assessment scale
intern
MTA, NS
Roos, N.M. de
Vitamin K intake and cardiovascular risk
intern
CE, DT
Name
Title
JC
Discipl
Bots, M.L.
Cardiac imaging and risk of CVD PAD patients: GROUND study
intern
CE
Bots, M.L.
Effects of increased convective clearance by online hemodiafiltration on
all cause mortality in chronic hemodialysis patients
extern
CE
Bots, M.L.
Optimal risk factor management in CRI patients and risk of CVD events:
MASTERPLAN
intern
CE
Other projects, ongoing
70 Julius Center for Health Sciences and Primary Care
Graaf, Y. van der,
Soedamah - Muthu,
S.S.
SMART: Second Manifestations of ARTerial disease
intern
CE
Hees, Y. van
Outcomes after aortic valve replacement. A prognostic cohort study on
survival, quality of life and costs
extern
CE
Iestra, J.A.
Effects of lifestyle and dietary habits on cardiovascular risk
intern
CE, DT
Jacobs, P.C.A.
Beyond clinical diagnosis: the prognostic value of unrequested
infromation in diagnostic imaging
joined
CE
Janssen, M.P.
Transfusion technology assessment
intern
MTA
Kluijtmans, M.
IPD analysis of on- versus off pump coronary bypass surgery
intern
CE
Linden, M.W. van der
The Dutch ADDITION Study as part of the Anglo-Danish-Dutch Study of
Intensive Treatment In People with Screen Detected Diabetes in Primary
Care
intern
CE, GP
Peeters, P.H.M. (*see
also Cancer)
PROSPECT: European prospective investigation into cancer and nutrition
intern
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
EPIC-Heart
intern
CE
Shahin, G.
Outcomes after mitral valve replacement. A prognostic cohort study
extern
CE
Soedamah - Muthu,
S.S., Grobbee, D.E.
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
Sonsma, A.C.M.
Application of nurse practitioners at the vascular center
intern
CE
Stel, H.F. van
Impact of secondary events on health status in patients with
cardiovascular disease
intern
MTA
Vergouwe, Y. (*see also Diagnostic prediction rules: innovative methods to improve their
Methodology)
applicability - postdoc project
intern
CE
Wamsteker, E.W.
intern
DT
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?
Annual Report 2005 71
Infectious diseases
PhD projects, finished 2005
Name
Title
JC
Discipl
Akkerman, A.E.
Determinants of prescribing antibiotics for respiratory tract infections in
Dutch general practice
intern
GP
Bootsma, M.C.J.
Mathematical studies of the dynamics of antibiotic resistance.
extern
CE
Brussee, J.E.
Asthma and wheezing in pre-school children: a birth cohort study
intern
CE
Giovannangelo,
M.E.C.A.
Exposures to biocontaminants found in house dust and their
determinants in schoolchildren in three European countries.
extern
CE
Koeman, M.
Ventilator Associated Pneumonia. Studies on prevention, diagnosis and
attributable mortality.
extern
CE
Oosterheert, J.J.
Diagnosis and treatment of community-acquired lower respiratory tract
infections: strategies for efficient management
extern
CE, MTA
Opstelten, W. (*see
also Methodology)
Herpes zoster and postherpetic neuralgia in general practice
joint
CE, GP,
MTA
Name
Title
JC
Discipl
Balemans, W.
A prospective cohort study into the role of early infections and genetics
in the development of asthma in young adults
extern
CE
Bont, J.
CELLO: complications among elderly of lower respiratory tract infections
intern
GP
Broekhuizen, B.D.L.
(*see also
Methodology)
FRESCO study: Diagnostic Strategies for COPD in coughing patients in
general practice
intern
CE, GP
Dool, C. van den
Mathematical modeling of influenza in health care setting
intern
CE, GP
Duijn, H.J. van
Views on respiratory tract symptoms; similarities and differences
between doctors and patients
intern
GP
Fonds, D.
Mathematical modeling as an alternative for clinical trials in predicting
intern
effectiveness of preventive measures for influenza in healthcare settings.
CE, GP
Geijer, R.M.M.
IJsselstein project: pneumonial function decay in smokers
intern
GP
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
Hooven, E.C. van den
Confounding by indication: a methodological approach
intern
CE, GP
Jansen, A.G.S.C.
PRIMAKID: Prevention of respiratory infections and management in
children with recurrent respiratory tract infections
intern
GP
Jong, B. de
Whistler: Wheezing illness study in Leidsche Rijn
intern
CE, GP
Jongerden, I.
Endotracheal suctioning in ICU patients: towards an evidence based
guideline
extern
CE, NS
Katier, N.
Lung function in early life: origin and consequences
intern
CE, GP
PhD projects, ongoing
72 Julius Center for Health Sciences and Primary Care
Looijmans - van den
Akker, I.
Evaluation of influenza vaccinations in healthy adults
intern
CE, GP
Matute, A.
Prevalence of infectious diseases and antibiotic diseases in Nicaragua
extern
GP
Muller, L.M.A.J. (*see
also CVD)
Diabetes and infections, Education learning in program for Health
Improvement (DELPHI)
intern
GP, NS
Niesink, A.
COPD care in general practice; evaluation of the copd-astma care
protocol
intern
PH
Obonyo, C.O.
Malaria, anaemia and antimalarial drug resistance in Africa
extern
CE
Posthouwer, D.
Optimizing treatment strategies for patients infected with hepatitis C: an extern
international cohort study
CE
Ruskamp, J.M.
The role of atopy and genetics in the development of upper respiratory
tract infections in children; an epidemiological study
extern
CE
Scholtens, S.
Breastfeeding in relation to growth, childhood overweight and asthma
in Dutch children. The PIAMA birth cohort study.
Extern
CE
Suarthana, E.
Development of diagnostic models for occupational asthma in the
framework of a health monitoring system
joint
CE
Vervoort, S.C.J.M.
Factors influencing therapy-fidelity in the view of HIV infected patients
extern
NS
extern
CE, GP,
MTA
Wijck, A. van (*see also Postherpetic Neuralgia
Methodology)
Other projects, ongoing
Name
Title
JC
Discipl
Bak, A.A.A.
Hepatitis C. trial
extern
CE
Hak, E.
Database Almere Health Care (GP info net)
joint
GP
Hak, E.
Utrecht GP Network (HNU)
intern
GP
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
Rovers, M.M.
Which children with acute otitis media benefit from treatment with
antibitoics? An individual patients data meta-analysis
joint
CE, GP
Strijp, J. van
In-vitro study of anti-inflammatory activity of Zithromax
intern
GP
Verhoeff, M.
The effectiveness of treatment with co-trimoxazol in children with
chronic otitis media
joint
CE
Welschen, I.
Optimalising antibiotic prescribing in respiratory tract infections in
general practice implementation in the Middle region of the
Netherlands.
intern
GP
Wouters, I.
Interindividual differences in response to occupational exposure to
endotoxin and interaction with atopy
extern
CE
Annual Report 2005 73
Cancer
PhD projects, finished 2005
Name
Title
JC
Discipl
Brouha, X. (*see also
Mental Health)
Advanced stage head and neck cancer: Factors related to delay in
seeking a diagnosis
extern
NS
Rinaldi, S.
Endogenous hormones and risk of breast cancer in women
extern
CE
Tromp, D.M. (*see also
Mental Health)
Head and neck cancer: Factors related to patient delay in seeking
medical care.
intern
NS
Name
Title
JC
Discipl
Braunius, W.
Diagnostic management in patients with head and neck malignancies
extern
CE
Duijnhoven, F.J.B. van
Genes, postmenopausal hormone therapy and mammographic density
intern
CE
Haars, G.
Caloric restriction during childhood and subsequent breast cancer risk
intern
CE
Kars, M.C.
Problems of parents with a child with cancer
intern
NS
Klerkx, W.
MR imaging: the efficacy of non-invasive techniques to detect lymph
node involvement in gynecologic malignancies.
extern
CE
May, A.M. (*see also
Mental Health)
ONCOREV: Effects of a multidisciplinary rehabilitation program for
cancer patients, combining physical exercise with psycho education: a
randomised controlled study.
intern
NS
Meiss - de Haas, C.
Multidisciplinary Oncological departments in general hosptals
intern
PH
Oosterom, M. (*see
also Mental Health)
NUCAI: The effect of comprehensive counselling by a nurse specialist on
depressive symptoms and quality of life: a randomised study in patients
with head and neck cancer.
intern
NS
Peters, H.G.M.
MR in non-palpable breast tumors
joint
CE
Verheus, M.
IGF polymorphisms and diet in relation to breast tissue density
intern
CE
PhD projects, ongoing
Other projects, finished 2005
Name
Title
JC
Discipl
Gils, C.H. van
Fruit and vegetables in relation to breast cancer - EPIC
intern
CE
Name
Title
JC
Discipl
Gamel, C.J.
Care for (relatives of) patients with cancer
intern
NS
Huitema, M.C.
Effectiveness of oncological follow-up by specialized nurses
extern
NS
Leeuw, J.R.J. de
Genetic Counselling
joint
NS
Monninkhof, E.M.
Physical activity and breast cancer risk: a trial in postmenopausal
women
intern
CE
Nijs, E. de, Ros, W.J.G.
Role of nursing in symptom management in chemotherapy and
radiotherapy - Anxiety
intern
NS
Noord, P.A.H. van
DOM project: Diagnostic Investigation Mamma Carcinoma
intern
CE
Peeters, P.H.M.
Phytoestrogen levels in EPIC
joint
CE
Other projects, ongoing
74 Julius Center for Health Sciences and Primary Care
Peeters, P.H.M. (*see
also CVD)
PROSPECT: European prospective investigation into cancer and nutrition
intern
CE
Portengen, L.
Nested case-control study on lung cancer and occupational bitumen
exposure
joint
CE
Annual Report 2005 75
Mental health
PhD projects, finished 2005
Name
Title
JC
Discipl
Brouha, X. (*see also
Cancer)
Advanced stage head and neck cancer: Factors related to delay in
seeking a diagnosis
extern
NS
Cremer, O.L. (*see also
Methodology)
Goal-directed intensive care of traumatic brain injury: pathophysiological extern
and clinical aspects
CE
Kamphuis, H.C.M. (*see In Rhythm. The impact of an ICD on quality of life.
also CVD)
intern
NS
Ravelli, D.P.
Deinstitutionalisation of mental health care in the Netherlands from
1993 - 2004.
intern
PH
Tromp, D.M. (*see also
Cancer)
Head and neck cancer: Factors related to patient delay in seeking
medical care.
intern
NS
Weijman, I. (*see also
CVD)
Diabetes at work. Fatigue in relation to job characteristics, diabetes
symptoms and self-management
intern
GP, NS
Name
Title
JC
Discipl
Berg, JP. van de
Specialised ALS care and quality of life
extern
CE
Bijkerk, C.J.
FIBRE: Dietary interventions in irritable bowel syndrome: soluble,
insoluble or no fibre?
intern
GP
Boonstra, G.
Quiting-study antipsychotic medicine
extern
CE
Bosman, M.
Prevention of self-harm in psychiatric inpatients
extern
NS
Bozkurt, O. (*see also
CVD)
UDES project pharmacy
joint
CE
Clignet, F.
Physical excercise in depressed elderly: The development of a nursing
intervention
extern
NS
Cohen, D. (*see also
CVD)
Diabetes mellitus in schizophrenia or schizoaffective disorder: an
iatrogenic or endogenic problem?
extern
CE
Fluttert, F.A.J.
Prevention of violence in forensic psychiatry
extern
NS
Houtjes, W.
Development of protocol for the assesment of needs and the application extern
of individualized nursing interventions in depressed elderly
NS
Joosten, G.
“Deciding Together”: A research into the effectiveness of making a
standardised treatment agreement in the addiction treatment care
extern
PH
Kamphuis, M.H. (*see
also CVD)
Depression and cardiovascular disease: the role of nutrition
intern
CE
Knol, M.J. (*see also
CVD)
Psychiatric comorbidity in diabetes (UDES-project JC)
joint
CE
Koekkoek, B.
The development and testing of a best-practice program for nursing care joint
for chronically depressed patients
NS
Korevaar, M.
Assertive treatment in outpatients with severe psychiatric disorders:
Aspect of nursing decision making.
joint
NS
Laan, W.
Acetylsalicylic acid as an adjuvant therapy for schizophrenia
intern
CE
PhD projects, ongoing
76 Julius Center for Health Sciences and Primary Care
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. de
Quality of the working alliance in Assertive Community Treatment
intern
NS
May, A.M. (*see also
Cancer)
ONCOREV: Effects of a multidisciplinary rehabilitation program for
cancer patients, combining physical exercise with psycho education: a
randomised controlled study.
intern
NS
Meijer, B
Determinants of cognitive decay in the HALE project
extern
CE
Mujakovic, S.
DIAMOND study: pharmacotherapeutic management of dyspepsia, stepup or top-down?
intern
CE, GP
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 counselling by a nurse specialist on
depressive symptoms and quality of life: a randomised study in patients
with head and neck cancer.
intern
NS
Pruijssers, A.
Multidisciplinary diagnostics of anxiety related behavioural disorders in
patients with intellectual disabilities
joint
NS
Putte, E.M. van der
Chronic fatigue syndrome in childhood: biological and psychological
determinants
extern
CE
Reincke, C.
A clinical prospective cross-sectional diagnostic study on the referral for
screening for epilepsy surgery
extern
CE
Smeets, H.
ARAMIS: analysis of the effectiveness of a PPI reduction programme
extern
GP
Velden, A.W. van der
ELISE: placebo determinants of PPI dependancy.
intern
GP, MTA
Vergouwen,T.
Adequate follow-up can’t be optional: Improving the management of
major depression in primary care
extern
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
Ververs, F.F.T.
Antidepressive medication during pregnancy: riscs for mother and child
extern
CE
Visscher, A.
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.
Prediction of depression in primary medical care: Application and
methodology
intern
CE, GP
Zwirs, B.
ADHD in children of different ethnic origin
extern
CE
Other projects, finished 2005
Name
Title
JC
Discipl
Burger, H.
The persistence of depression score (PDS)
joint
CE
Donkers, M.
Relaxation by physical exercise
intern
CE, GP
O, Y.L., Raijmakers,
V.J.A.
Prevalence and incidence of psychological problems, need for mental
health care and care provision in the elderly in the region Utrecht
intern
PH
Raijmakers, V.J.A., O,
Y.L.
Prevalence and incidence of psychological problems, need for mental
health care and care provision for children in the region Utrecht
intern
PH
Annual Report 2005 77
Other projects, ongoing
Name
Title
JC
Discipl
Beem, E.
Regional case registry of psychiatric disturbances in the West and
Central Netherlands
intern
CE
Boter, H.
The european first episode schizophrenia trial
extern
CE
Groenendijk J.J.
Patients and GP’s perception of IBS
intern
GP
Hage, S.
Self-management strategies for adolescents with violent behaviour
extern
NS
Matthijs, W.
Treatment of children with functional disorders or behaviour disorders
joint
MTA
Megens, Y.A.C.T.
Effectiveness of training programme interactive skills in schizophrenia
care
intern
NS
Nuboer, V.S.P.
Prevention of suicide in patients with schizophrenia
intern
NS
Peijnenburg, R.
The development of a nursing guideline aimed at the reduction of
agitated behaviors in patients with dementia
joint
NS
Raijmakers, V.J.A.
Monitoring quality of care for substance dependent patients
joint
PH
Vacature,
Development and testing of an evidence based nursing guideline aimed
at effective care for suicidal patients with schizophrenia or related
disorders
intern
NS
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
Weert - van Oene, G.H.
de
Early diagnosis in child health centers of boisterous behavior in children
of 0-4 years
intern
PH
78 Julius Center for Health Sciences and Primary Care
Research methodology and biostatistics
PhD projects, finished 2005
Name
Title
JC
Discipl
Biesheuvel, C.J.
Diagnostic research: improvements in design and analysis
intern
CE
Cremer, O.L. (*see also
Mental Health)
Goal-directed intensive care of traumatic brain injury: pathophysiological extern
and clinical aspects
CE
Opstelten, W. (*see
also Infectious
Diseases)
Herpes zoster and postherpetic neuralgia in general practice
joint
CE, GP,
MTA
Oudega, R. (*see also
CVD)
Diagnosing deep venous thrombosis in primary care
intern
GP
Name
Title
JC
Discipl
Bijker, J.
Perioperative blood pressure management to improve postoperative
outcome
joint
CE
Bosch, J.E. van den
Risk management of peri and postoperative complications
Broekhuizen, B.D.L.
(*see also INF)
FRESCO study: Diagnostic Strategies for COPD in coughing patients in
general practice
intern
CE, GP
Dieleman, S.
Cognitive outcome after coronary bypass surgery
joint
CE
Eck, J.W.M. van (*see
also CVD)
Complications in first year after pacemaker implants
intern
CE
Graaf - Verhave, R. van
der
Equity issues in research ethics
intern
MTA
Janssen, K.J.M. (*see
also CVD)
Diagnostic and prognostic prediction rules: innovative methods to
improve their applicability - PhD project
intern
CE
Koopman, L.
Methodological chalenges in IPD meta analysis
intern
CE
Molenaar, E.A.
Research and development LRGP/VWS
intern
CE, GP
Speets, A.
The value of diagnostic imaging in general practice
Toll, D.B. (*see also
CVD)
Implementing a diagnostic algorithm to rule out deep venous
thrombosis in primary care
intern
CE, GP
Uijl, S. (*see also CVD)
Optimal diagnostic routing to determine the indication of surgery in
epilepsy patients
extern
CE
Verschuuren, M.
Pine HTA study: evaluation of health profiles. versus standard Qalys
intern
MTA
extern
CE, GP,
MTA
PhD projects, ongoing
Wijck, A. van (*see also Postherpetic Neuralgia
Infectious Diseases)
CE
CE, GP
Annual Report 2005 79
Other projects, ongoing
Name
Title
JC
Discipl
Janssen, M.P.
Viral transmission risks of plasma derived products
joint
MTA
Kaleta, M.P.
Monitoring of Dutch blooddonor viral infection incidence rates
intern
MTA
Rovers, M.M.
Methodological challenges of subgroup analyses in IPD meta-analyses
intern
CE
intern
CE
Vergouwe, Y. (*see also Diagnostic prediction rules: innovative methods to improve their
CVD)
applicability - postdoc project
80 Julius Center for Health Sciences and Primary Care
Miscellaneaous
PhD projects, finished 2005
Name
Title
JC
Discipl
Bergman, G.
Manipulative therapy for shoulder complaints in general practice.
extern
CE
Bijlsma, T.S.
Trauma care in the Netherlands: Evaluating aspects of the quality of
treatment
extern
CE
Kolk - Kousemaker, M.J. The Policy of The White Cross, The Green Cross and The White-Yellow
van de
Cross during the period 1875-1945 (Dutch)
intern
PH, NS
Konijnenberg, Y.
Unexplained chronic pain in children: diagnostic aspects in general
paediatrics.
extern
CE
Kuijpers, T.
Shoulder Pain. Prediction of outcome in primary care
extern
CE
Kwee, A.
Caesarean section in the Netherlands. Policy, prevention and long-term
consequences
extern
CE
Name
Title
JC
Discipl
Berg, B. van den
Medically unexplained symptoms among survivors of the fireworks
disaster (Enschede)
extern
CE
Bollen, C.W.
High frequency oscillation ventilation versus conventional ventilation in
children admitted to pediatric intensive care units
extern
CE
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, E.C.
Support of parents of premature children
extern
NS
Buiting, H.
Evaluation of the law on euthanasia
extern
MTA
Chaves, L.
Prevention of pressure ulcers in home care
extern
NS
Eland-Kok, P.
A patient portal for patients with constitutional eczema: feasibility and
effectiveness
extern
NS
Geraets, J.
Operant behavioural treatment for chronic shoulder disorders
extern
CE
Hoogerduijn, J.
Prevention of complications in elderly after hospital admission
joint
NS
Iestra, J.A.
Prognosis, Proof and Priorities in Dietetic Practice.
intern
CE, DT
Jacquet, JB
Prediction of functional recovery and work impairment after nerval
damage of the upper extremity.
extern
CE
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
Klijn, A.
Efficacy of home-uroflowmetry in children with dysfunctional voiding
(UFO)
extern
CE
Loth, C.A.
Nursing care in out-patient Methadone programs in Holland
extern
NS
Medendorp-van Os, H.
JEUK: Development, evaluation and implementation of a
multidisciplinary nursing program “Coping with Itch”.
extern
NS
PhD projects, ongoing
Annual Report 2005 81
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.
Development and validation of a multidisciplinary protocol for
withdrawal of artificial breathing on IC units
joint
NS
Rademakers, K.
Additional value of MRI in prediction of psychomotorical development in extern
premature children: a cost benefit analysis
CE
Simkens, A.B.M.
Evaluation of Physician Assistants in the Primary Care Setting
intern
PH
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
Vallenga, D.
Risk management in care of mentally retarded patients with epilepsy
extern
NS
Other projects, finished 2005
Name
Title
JC
Discipl
Geisel, S.
The role of melatonin in children with enuresis nocturna
extern
CE
Villevoye, D.P.J.
Cooperation between preventive and interventive MDs in treatment of
patients with persistent health problems
extern
PH
Name
Title
JC
Discipl
Bie - de Waal, M.N.A.
de
Reduction of care-delay for multi trauma patients
intern
PH
Bie - de Waal, M.N.A.
de
Stop the care-stops
intern
PH
Bolleurs, C.
Nutrition anamnesis
intern
DT
Buskens, E.
PATMAN: Patient workflow management systems
intern
MTA
Grypdonck, M.H.F.
Improving the care of chronically ill through qualitative research
joint
NS
Jukema, J.S.
Presence in caring relationships
joint
NS
Lemmens, L.
Implementation of POS clinics in Dutch hospitals
extern
CE
Lendemeijer, H.H.G.M.
Application of seclusion and restraint in health care
intern
NS
Linden, B.A. van der
Meaning of American integrated care programs to Dutch chronically ill
patients
intern
PH
Niesink, A.
Telemonitoring of COPD patients
intern
PH
Rooij, S.
Early recognition in elderly hopistal patients who are at risk for
functional impairments
joint
NS
Schrijvers, A.J.P.
Evaluation of periodical indicators of youth health care in child health
centers
intern
PH
Weert - van Oene, G.H.
de
The association between interpersonal behavior and helping alliance in
substance dependent patients
intern
PH
Weldam, S.D.W.
Guideline development to stimulate fluid intake
extern
NS
Zweers - de Groot,
J.A.M.
Implementation of care homes
intern
NS
Other projects, ongoing
82 Julius Center for Health Sciences and Primary Care
Research services
Projects 2005 finished
Project
Title
PLUTO STUDY
UVB light therapy at home versus in the hospital
M/DM
CT
Projects, ongoing
Project
Title
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
ADVANCE
Action in Diabetes and Vascular disease; pretax and Diamicron MR
Controlled Evaluation
M
CT
AUDITOR
Atherosclerosis underlying development assessed by intina-media
thickness in patients on Rimonabant
Site
CT
Ascertain
Assesment of everolimus in addition to calcineurin inhibitors reduction
in maintenance renal transplant recipients
Site
(CIMT
only)
CT
Aspirin/
Schizophrenia
Acetylsalicylic acid as an adjuvant therapy for schizophrenia
M/DM
Other
Cello
A prediction rule for complications in elderly with lower respiratory tract
infections in primary care: a prospective study
Adm./
DM
Other
CONTRAST
The Dutch Convective Transport Study
M/DM
CT
CIRA
Study on chronic hepatits-C treatment with interferon alpha, ribavirin
and amantadine
M/DM
CT
DEPRESSIE
Pharmacological Treatment of Psychotic Depression. Comparance of
efficacy at 7 weeks after treatment with venlafaxine, imipramine,
venlafaxine + imipramine.
M/DM
CT
DIS
Diabeteszorg Implementatie Studie
Adm./
DM
Other
DREAM
Dutch Randomised Endovascular Aneurysm Management Trial
M/DM
CT
ELISE
Comparison of the percentage chronic on-demand users treated with 20 M/DM
mg pantoprazole on- demand and placebo o.d. versus placebo ondemand and 20 mg pantoprazole o.d. after symptom relief with 20 mg
pantoprazole o.d.
CT
The EUropean First Episode Schizophrenia Trial
M/DM
CT
EVISTA
A trial on the efficacy of tibolone and raloxifene for the maintenance of
skeletal muscle strength, bone mineral density, etc. in late
postmenopausal women with an increased fall risk.
Site
(dexa’s
only)
CT
DELPHI
Optimale behandelstrategie van infecties bij mensen met diabetes
mellitus (focus groepen)
Adm./
DM
Other
FOLLOW-PACE
Complications in first year after pacemaker implants
DM
Other
EUFEST
Annual Report 2005 83
ILLUMINATE
Phase 3 multi-center, double-blind, randomized, parallel group
evaluation of the fixed combination torcetrapib/atorvastatin,
administered orally, once daily (QD), compared with atorvastatin alone,
on the occurence of major cardiovascular events in subjects with
coronary heart disease or risk equivalents
Site
CT
JUPITER
Justification for the use of statins in primary prevention: an intervention
trial evaluating Rosuvastatin
Site
CT
K-3
A phase IIa multicentre, randomised, double-blind, double-dummy study
to evaluate the afficacy and safety of K-III versus Fenofibrate in patients
with hyperlipidaemaia
Site
CT
LIFT
Long-term Intervention of Fractures with Tibolone
Site
CT
LRGP
Utrecht Health Monitoring Study Leidsche Rijn
Site/DM
Other
MASTERPLAN
Multifactorial Approach and Superior Treatment Efficacy in renal patients M/DM
with the aid of nurse practitioners
CT
METEOR
Effects on intimia media thickness: an evaluation of Rosuvastatin 40 mg. Site
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
PFIZER/MD STUDY
Phase 3, multi-center, double-blind, randomized, parallel group, carotid
B-mode ultrasound evaluation of the anti-atherosclerotic efficacy, safety
and tolerability of fixed combination CP- 529, 414/Atorvastatin,
administered orally, once daily (QD) for 24 months, compared with
atorvastatin alone, in subjects with mixed hyperlipidemia, A5091004
Site
CT
PRIMAKID
Prevention of Respiratory Infections and Management among children
Site/DM
CT
SHAPE
Relatie tussen lichaamsbeweging en borstkanker bij postmenopausale
vrouwen (50-69 jaar)
Site/DM
CT
SHARP
Study on Heart And Renal Protection
M
CT
SUMO
An 18-week randomised, double-blind, parallel group, placebocontrolled, study to investigate the lipid lowering effect, safety,
tolerability and pharmacokinetics of SM-797 in subjects with mild to
moderate dyslipidaemia.
Site
CT
UHFO-DD
Utrecht Heart Failure Study – Diagnostics
M/DM
Other
YOGHURT/BP
Second efficacy study (E-2) of single shot yoghurt drink with dairy
peptides on blood pressure in mild hypertensives.
Site/M/
DM
CT
CT
= Clinical Trial
84 Julius Center for Health Sciences and Primary Care
Vascular imaging center (VIC)
Projects 2005 finished
FACIT st
Measurement of carotid distensibility in: single- center randomised
double-blind placebo controlled trial on the 3 year effect of increased
folate intake
CT
FACIT IMT
Measurement of carotid intima-media thickness in: a single-center
randomised double-blind placebo controlled trial on the 3 year effect of
increased folate intake
CIMT
CT
AGES
Training and quality control aspects of carotid intima-media thickness
measurements in the AGES study in Reijkjavik, Iceland
CIMT
other
Fenland
Ultrasound training of abdominal fat measurements
Abdominal
fat
other
Boston
Training and quality control aspects of carotid intima-media thickness
measurements
CIMT
other
Organisation
Title
Measurement
AdRem
ADVANCE Retinal Measurements, a large sub-study of ADVANCE on
diabetic retinopathy and vascular retinal changes
Retinal
CT
A5091003
Measurement of carotid intima-media thickness in a multi centre
randomised controlled trial on lipid lowering (CP-529,414/Atorvastatin,
Administered Orally, Once daily (QD) for 24 months, Compared with
Atorvastatin alone) on progression of carotid intima-media thickness in
patients with Heterozygous Familial Hypercholesterolaemia:1003 FH
CIMT
CT
A5091004
Measurement of carotid intima-media thickness in a multi centre
randomised controlled trial on lipid lowering (CP-529,414/Atorvastatin,
Administered Orally, Once daily (QD) for 24 months, Compared with
Atorvastatin alone) on progression of carotid intima-media thickness in
subjects with Mixed Hyperlipidemia: 1004MH
CIMT
CT
METEOR
Measurement of carotid intima-media thickness in: a randomized,
placebo-controlled double-blind trial on the effect of rosuvastatin on
progression of CIMT
CIMT
CT
Masterplan
Multifactorial Approach and Superior Treatment Efficacy in renal patients CIMT
with the aid of nurse practitioners- IMT measurements
CT
Contrast
The Dutch Convective Transport Study - IMT measurements
CIMT
CT
Heart-activ
Heart Health effects of long-term intake of a pro-activ spread
(margarine) on progression of carotid intima-media thickness.
Orally, twice daily for 36 months, compared with margarine without
plant sterols on progression of carotid intima-media thickness in
subjects with slightly elevated cholesterol.
CIMT
CT
Cumulus II
Measurement of percentage dense gland tissue in mammogramms
Other
other
Projects, ongoing
For all studies datamanagement is performed by the Julius Center.
CIMT
= Carotid intima-media thickness
CT = Clinical Trial
Annual Report 2005 85
Data management
Projects without participation of research services or VIC.
Projects 2005 finished
Project
DEVENTER HEART FAILURE
Vergelijking van hartfalen poli t.o.v. reguliere behandel-methode van
hartpatienten.
CT
DIOGENES
Opbouw diabeten cohort t.b.v. genetische achtergrond
cohort
EBCR
Internetapplicatie t.bv. studentenonderwijs
other
MITRAL VALVE
Uitkomst na mitraal klep vervanging. Een prognostische studie
other
ONDERWIJSINSTITUUT II
Verwerking onderwijsevaluaties
other
PRE-OPERATIEVE SCREENING
Onderzoek naar factoren die van invloed zijn op de implementatie van pre- other
operatieve screeningklinieken
PURSEVALUE II
Observationeel onderzoek naar voorkomen en behandeling van decubitus
OBS
SQUARES
Uitkomst na aorta klep vervanging. Een prognostische studie naar
overleving, kwaliteit van leven en kosten
other
VENUS
Vascular prEvention by Nurses Study
CT
BLOEDBANK
Datamining gegevens van bloedbanken
other
CHECK
Reuma-onderzoek DIGD
cohort
COCO
Onderzoek naar BLWI bij kinderen
CT
DIASULIN
Trial bij diabetes type 2 patienten in Breda e.o.
CT
DOM
Utrechts cohort t.b.v. opsporing risicofactoren voor onstaan van
borstkanker
cohort
FIBRE
Dieet interventies bij Prikkelbare Darm Syndroom: oplosbaar, onoplosbaar
of geen vezels?
CT
GROUND
Multicenter trial bij patienten met perifeer vaatlijden, waarbij gekeken
wordt of imaging en vervolgbehandeling gevolgen heeft voor
cardiovasculairrisico binnen 5 jaar.
CT
HNU
Huisartsen Netwerk Utrecht, database gevuld met gegevens van 6
huisartsenpraktijken in regio Utrecht
cohort
IMPETUS
Implementatie en evaluatie van transmurale werkafspraken diabets mellitus CT
KEMA
Verwerking vragenlijsten
other
LEUKO
Leukemie-studie bij WKZ
other
NS-2
Nationale Studie 2, database gevuld met gegevens van 195 huisartsen
verspreid over Nederland
cohort
NUCAI
Trial waarbij patienten met kanker in hoofd-halsgebeid op reguliere wijze
wordt behandeld t.o.v. inzet van counseling
CT
ODIN
Ontspanning door Inspanning
other
ONCOREV
Effectiviteit van oncoligische revalidatie op kwaliteit van leven
CT
PANTER
PAncreatitis, Necrosectomie versus minimaal invasieve sTEp up benadeRing CT
PATIENTVEILIGHEID
Onderzoek naar patientveiligheid binnen UMC Utrecht
other
PEDNET
European paediatric network for Haemophilia management
cohort
PROSPECT
Utrechts cohort t.b.v. leefgewoonten en kanker en hart-en vaatziekten
cohort
Projects, ongoing
86 Julius Center for Health Sciences and Primary Care
SDD-TRIAL
Toediening antibiotica op de IC
CT
SPAIN
Begeleiding via Internet van vaatpatienten
other
SPIN UTI
Trial mbt wel/niet preventief geven van antibiotica bij kinderen met spina
bifida
CT
ST. QUADRAET
Database gevuld met gegevens alle 20 huisartsenpraktijken in Almere
cohort
VAN PELT
Kinderen met reuma
other
CT = Clinical Trial
Annual Report 2005 87
Publications 2005
PhD thesis
1.
Akkerman, A.E. Determinants of prescribing antibiotics for respiratory tract
infections in Dutch general practice. PhD-thesis Utrecht University, 01-11-2005,
Supervisor: Verheij, Th.J.M., Co-supervisors: Kuyvenhoven, M.M., Wouden, J.C.
van der.
2.
Atsma, F. Reproductive factors and cardiovascular disease risk in postmenopausal
women. PhD-thesis Utrecht University, 02-12-2005, Supervisor: Grobbee, D.E.,
Co-supervisors: Bartelink, M.E.L., Schouw, Y.T. van der.
3.
Bergman, G.J. Manipulative therapy for shoulder complaints in general practice.
PhD-thesis Groningen University, 12-01-2005, Supervisors: Meijboom-de Jong, B.,
Postema, K., Co-supervisors: Winters, J.C., Heijden, G.M.G. van der.
4.
Biesheuvel, C.J. Diagnostic Research: improvements in design and analysis. PhDthesis Utrecht University, 27-04-2005, Supervisors: Grobbee, D.E., Moons, K.G.M..
5.
Bijlsma, T.S. Trauma care in The Netherlands: Evaluating aspects of the quality of
treatment. PhD-thesis Utrecht University, 30-09-2005, Supervisors: Werken, Chr.
van der, Graaf, Y. van der.
6.
Bootsma, M.C. Mathematical studies of the dynamics of antibiotic resistance.
PhD-thesis Utrecht University, 23-05-2005, Supervisors: Diekmann, O., Bonten,
M.J.M.
7.
Brouha, X.D.R. Advanced stage head and neck cancer. Factors related to delay in
seeking a diagnosis. PhD-thesis Utrecht University, 14-11-2005, Supervisors:
Winnubst, J.A.M., Hordijk, G.J., Co-supervisor: Leeuw, J.R.J. de.
8.
Brussee, J.E. Asthma and wheezing in pre-school children: a birth cohort study.
PhD-thesis Utrecht University, 25-11-2005, Supervisors: Brunekreef, B., Jongste,
J.C. de, Co-supervisor: Smit, H.A.
9.
Cremer, O.L. Goal-directed intensive care of traumatic brain injury:
pathofysiological and clinical aspects. PhD-thesis Utrecht University, 05-10-2005,
Supervisors: Kalkman, C.J., Moons, K.G.M., Co-supervisor: G.W. van Dijk.
88 Julius Center for Health Sciences and Primary Care
10. Dijk, J.M. Is new always better? Vascular risk factors in patients with manifest
arterial disease. PhD-thesis Utrecht University, 15-03-2005, Supervisors: Graaf, Y.
van der, Grobbee, D.E., Co-supervisor: Bots, M.L.
11.
Dijk, K. van. Explaining variation in bleeding pattern of severe haemophilia.
PhD-thesis Utrecht University, 26-04-2005, Supervisors: Grobbee, D.E., Cosupervisors: Bom, J.G. van der, Berg, H.M. van den.
12.
Elvan - Taspinar, A. Central hemodynamics in pregnancy. PhD-thesis Utrecht
University, 08-09-2005, Supervisors: Bruinse, H.W., Koomans, H.A., Cosupervisors: Franx, A., Bots, M.L.
13.
Giovannangelo, M.E.C.A. Exposures to biocontaminants found in house dust and
their determinants in schoolchildren in three European countries. PhD-thesis
Utrecht University, 22-09-2005, Supervisor: Brunekreef, B., Co-supervisor: Hoek,
G.
14.
Hartog, J.J. de Cardiorespiratory effects of fine and ultrafine ambient particles.
PhD-thesis Utrecht University, 27-09-2005, Supervisors: Brunekreef, B., Hoek, G.
15.
Kamphuis, H.C.M. In Rhythm: the impact of an ICD on quality of life. PhDthesis Utrecht University, 11-01-2005, Supervisors: Winnubst, J.A.M., Hauer,
R.N.W., Co-supervisor: Leeuw, J.R.J. de.
16.
Koek, H.L. Acute myocardial infarction: linkage of national registers. PhD-thesis
Utrecht University, 11-11-2005, Supervisor: Grobbee, D.E., Co-supervisor: Bots,
M.L..
17.
Koeman, M. Ventilator Associated Pneumonia. Studies on prevention, diagnosis,
and attributable mortality. PhD-thesis Utrecht University, 15-09-2005, Supervisors:
Bonten, M.J.M., Hoepelman, I.M.
18.
Kolk-Kousemaker, M. van der Het beleid van Het Witte Kruis, Het Groene Kruis
en Het Wit-Gele Kruis over de periode 1875-1945. PhD-thesis Utrecht University,
08-03-2005, Supervisors: Schrijvers, A.J.P., Duijnstee, M.S.H., Co-supervisor:
Raak, A.J.A. van.
19.
Konijnenberg, A.Y. Unexplained chronic pain in children: diagnostic aspects in
general paediatrics. PhD-thesis Utrecht University, 01-04-2005, Supervisors:
Kimpen, J.L.L., Buitelaar, J.K., Co-supervisors: Graeff-Meeder, E.R. de, Uiterwaal,
C.S.P.M.
Annual Report 2005 89
20.
Kuijpers, A.C. Shoulder Pain. Prediction of outcome in primary care. PhD-thesis
Vrije Universiteit Amsterdam, 14-10-2005, Supervisor: Bouter, L.M., Co-supervisors: Windt, D.A.W.M. van der, Heijden, G.M.G. van der.
21.
Kwee, A. Caesarean section in the Netherlands. PhD-thesis Utrecht University, 1110-2005, Supervisors: Bruinse, H.W., Visser, G.H.A., Co-supervisor: Bots, M.L.
22.
Oosterheert, J.J. Diagnosis and treatment of community-acquired lower
respiratory tract infections. Strategies for efficent management. PhD-thesis
Utrecht University, 15-04-2005, Supervisors: Hoepelman, I.M., Bonten, M.J.M.,
Co-supervisor: Schneider, M.M.E.
23. Opstelten, W. Herpes zoster and postherpetic neuralgia in general practice. PhDthesis Utrecht University, 11-10-2005, Supervisors: Verheij, Th.J.M., Kalkman, C.J.,
Moons, K.G.M., Co-supervisor: Essen, G.A. van.
24. Oudega, R. Diagnosis deep venous thrombosis in primary care. PhD-thesis
Utrecht University, 30-09-2005, Supervisors: Hoes, A.W., Moons, K.G.M. .
25.
Prinssen, M. Dream. Dutch Randomised Endovascular Aneurysm Management
Trial. PhD-thesis Radboud University Nijmegen, 09-09-2005, Supervisors: J.D.
Blankensteijn, Grobbee, D.E., Co-supervisor: Buskens, E.. (CUM LAUDE)
26.
Ravelli, D.P. Deinstitutionalisation of mental health care in the Netherlands from
1993-2004. PhD-thesis Utrecht University, 04-03-2005, Supervisors: Schrijvers,
A.J.P., Engeland, H. van.
27.
Rinaldi, S. Endogenous Hormones and Risk of Breast Cancer in women. PhDthesis Utrecht University, 05-12-2005, Supervisors: Grobbee, D.E., Co-supervisor:
Kaaks, R., Peeters, P.H.M..
28.
Rutten, F.H. Heart Failure in COPD. PhD-thesis Utrecht University, 04-10-2005,
Supervisors: Hoes, A.W., Grobbee, D.E., Lammers, J.W.J.
29.
Schrijver, E.L.L.M. de Secondary prevention of stroke. The rationale of
antithrombotic treatment. PhD-thesis Utrecht University, 11-03-2005, Supervisors:
Algra, A., Gijn, J. van.
30.
Stork, S.F.J. Endocrine and inflammatory markers, atherosclerosis and
cardiovascular risk. PhD-thesis Utrecht University, 18-11-2005, Supervisors:
Grobbee, D.E., Angermann, C.E., Co-supervisors: Bots, M.L., Schacky, C. von.
90 Julius Center for Health Sciences and Primary Care
31.
Trijp, M.J.C.A. Augmentation index, an indicator of cardiovascular risk? PhDthesis Utrecht University, 21-01-2005, Supervisor: Grobbee, D.E., Co-supervisor:
Bots, M.L.
32.
Tromp, D.M. Head and neck cancer: Factors related to patient delay in seeking
medical care. PhD-thesis Utrecht University, 01-06-2005, Supervisors: Winnubst,
J.A.M., Hordijk, G.J., Co-supervisor: Leeuw, J.R.J. de.
33.
Weijman, I. Diabetes at Work. Fatigue in relation to job characteristics, diabetes
symptoms and self-management. PhD-thesis Utrecht University, 01-03-2005,
Supervisors: Winnubst, J.A.M., Rutten, G.E.H.M., Schaufeli, W.B., Co-supervisor:
Ros, W.J.G.
Books and book chapters
1.
Balen, F.A.M. van (2005). Acute otitis media. In Eekhof, J.A.H., Knuistingh
Neven, A., Verheij, Th.J.M. (Eds.), Kleine kwalen bij kinderen (pp. 228-233).
Maarssen: Elsevier Gezondheidszorg.
2.
Bergman, G.J., Winters, J., Groenier, K.H., Pool, J., Meyboom-de Jong, B.,
Postema, K., Heijden, G.M.G. van der (2005). Manipulaties en mobilisaties bji
schouderklachten, een gerandomiseerd klinisch onderzoek. In Marinus (Ed.),
Jaarboek Fysiotherapie Kinesitherapie 2006. Houten: Bohn Stafleu Van Loghum.
3.
Bootsma, M.C., Bonten, M.J.M., Diekmann, O. (2004). Estimating transmission
parameters for infectious diseases in small hospital units. In Design and Analysis
of Infectious Disease Studies (pp. 2603-2603).
4.
Bots, M.L., Leest, L.A.T.M. van, Koek, H.L., Trijp, M.J.C.A., Dis, S.J. van, Peters,
R.J.G., Verschuren, W.M.M. (Eds.). (2005). Hart- en vaatziekten in Nederland
2005, cijfers over risicofactoren, ziekte, behandeling en sterfte. Den Haag:
Nederlandse Hartstichting.
5.
Brummer, R.M.J., Vries, J.H.M. de, Steenhagen, E. (2005). Voedings- en dieetleer.
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A, D.L. van der, Peeters, P.H.M., Grobbee, D.E., Marx, J.J.M., Schouw, Y.T. van
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106 Julius Center for Health Sciences and Primary Care
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M., Malaveille, C., Matullo, G., Overvad, K., Tjonneland, A., Clavel Chapelon, F.,
Linseisen, J., Boeing, H.H., Trichopoulou, A., Palli, D., Peluso, M., Krogh, V.,
Tumino, R., Panico, S., Bueno-de-Mesquita, H.B., Peeters, P.H.M., Lund, E.,
Agudo, A., Martinez, C., Dorronsoro, M., Barricarte, A., Chirlaque, M.D., Quiros,
J.R., Berglund, G., Jarvholm, B., Hallmans, G., Day, N.E., Allen, N., Saracci, R.,
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smoking-related disease in never smokers and former smokers in the European
prospective investigation into cancer and nutrition prospective study. Cancer
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(2005). Analysis of under- and overprescribing of antibiotics in acute otitis media
in general practice. Journal of Antimicrobial Chemotherapy, 56(3), 569-574.
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(2005). Determinants of antibiotic overprescribing in respiratory tract infections
in general practice. Journal of Antimicrobial Chemotherapy, 56(5), 930-936.
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(2005). Prescribing antibiotics for respiratory tract infections by GPs:
management and prescriber characteristics. British Journal of General Practice,
55(511), 114-118.
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Al-Delaimy, W.K., Slimani, N., Ferrari, P., Key, T.J., Spencer, E., Johansson, I.,
Johansson, G., Mattisson, I., Wirfalt, E., Sieri, S., Agudo, A., Celentano, E., Palli,
D., Sacerdote, C., Tumino, R., Dorronsoro, M., Ocke, MC, Bueno-de-Mesquita,
H.B., Overvad, K., Chirlaque, M.D., Trichopoulou, A., Naska, A., Tjonneland, A.,
Olsen, A., Lund, E., Skeie, G., Ardanaz, E., Kesse, E., Boutron-Ruault, M.C.,
Clavel-Chapelon, F., Bingham, S, Welch, A.A., Martinez-Garcia, C., Nagel, G.,
Linseisen, J., Quiros, J.R., Peeters, P.H.M., Gils, C.H. van, Boeing, H.H., Kappel,
A.L., Steghens, J.P., Riboli, E. (2005). Plasma carotenoids as biomarkers of intake
of fruits and vegetables: ecological-level correlations in the European Prospective
Investigation into Cancer and Nutrition (EPIC). European Journal of Clinical
Nutrition, 59(12), 1397-1408.
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Al-Delaimy, W.K., Ferrari, P., Slimani, N., Pala, V., Johansson, I., Nilsson, S.,
Mattisson, I., Wirfalt, E., Galasso, R., Palli, D., Vineis, P., Tumino, R., Dorronsoro,
M., Pera, G., Ocke, MC, Bueno-de-Mesquita, H.B., Overvad, K., Chirlaque, M.D.,
Trichopoulou, A., Naska, A., Tjonneland, A., Olsen, A., Lund, E., Alsaker, E.,
Barricarte, A., Kesse, E., Boutron-Ruault, M.C., Clavel-Chapelon, F., Key, T.J.,
Spencer, E., Bingham, S, Welch, A.A., Sanchez-Perez, M.J., Nagel, G., Linseisen, J.,
Quiros, J.R., Peeters, P.H.M., Gils, C.H. van, Boeing, H.H., Kappel, A.L., Steghens,
J.P., Riboli, E. (2005). Plasma carotenoids as biomarkers of intake of fruits and
vegetables: individual-level correlations in the European Prospective Investigation
into Cancer and Nutrition (EPIC). European Journal of Clinical Nutrition, 59(12),
1387-1396.
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Aleman, A., Muller, M., Haan, E.H.F. de, Schouw, Y.T. van der (2005). Vascular
risk factors and cognitive function in a sample of independently living men.
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Arbous, M.S., Meursing, A.E., Kleef, J.W. van, Lange, J.J. de, Spoormans, H.H.,
Touw, P.P.J., Werner, F.M., Grobbee, D.E. (2005). Impact of anesthesia
management characteristics on severe morbidity and mortality. Anesthesiology,
102(2), 257-268.
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Ariesen, M.J., Algra, A., Worp, H.B. van der, Rinkel, G.J.E. (2005). Applicability
and relevance of models that predict short term outcome after intracerebral
haemorrhage. Journal of Neurology, Neurosurgery and Psychiatry, 76(6), 839-44.
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Ariesen, M.J., Tangelder, M.J., Lawson, J.A., Eikelboom, B.C., Grobbee, D.E.,
Algra, A. (2005). Risk of major haemorrhage in patients after infrainguinal
venous bypass surgery: therapeutic consequences? The Dutch BOA (Bypass Oral
Anticoagulants or Aspirin) Study. European Journal of Vascular and Endovascular
Surgery, 30, 154-159.
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Asseldonk, J.T.H. van, Berg, L.H. van den, Kalmijn, S., Wokke, J.H.J., Franssen, H.
(2005). Criteria for demyelination based on the maximum slowing due to axonal
degeneration, determined after warming in water at 37 degrees C: diagnostic yield
in chronic inflammatory demyelinating polyneuropathy. Brain, 128(Pt 4), 880-91.
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Atsma, F., Bartelink, M.L., Grobbee, D.E., Schouw, Y.T. van der (2005). Best
reproducibility of the ankle-arm index was calculated using Doppler and dividing
108 Julius Center for Health Sciences and Primary Care
highest ankle pressure by highest arm pressure. Journal of Clinical Epidemiology,
58(12), 1282-1288.
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Annual Report 2005 147
Organizational structure
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