• Expert Views on Their Role as Policy Advisor: Pilot Study for the Cases of Electromagnetic Fields, Particulate Matter, and Antimicrobial Resistance.

      Spruijt, Pita; Knol, Anne B; Petersen, Arthur C; Lebret, Erik (2018-10-31)
      This perspective presents empirical data to demonstrate the existence of different expert views on scientific policy advice on complex environmental health issues. These views are partly research-field specific. According to scientific literature, experts differ in the way they provide policy advice on complex issues such as electromagnetic fields (EMF), particulate matter (PM), and antimicrobial resistance (AMR). Where some experts feel their primary task is to carry out fundamental research, others actively engage in the policy dialogue. Although the literature provides ideas about expert roles, there exists little empirical underpinning. Our aim is to gather empirical evidence about expert roles. The results of an international study indicated that experts on EMF, PM, and AMR differ in the way they view their role in the policy dialogue. For example, experts differed in their views on the need for precaution and their motivation to initiate stakeholder cooperation. Besides, most experts thought that their views on the risks of EMF/PM/AMR did not differ from those of colleagues. Great dissensus was found in views on the best ways of managing risks and uncertainties. In conclusion, the theoretical ideal-typical roles from the literature can be identified to a certain extent.
    • Explaining sex differences in chronic musculoskeletal pain in a general population.

      Wijnhoven, Hanneke A H; Vet, Henrica C W de; Picavet, H Susan J (2006-09-01)
      Many studies report a female predominance in the prevalence of chronic musculoskeletal pain (CMP) but the mechanisms explaining these sex differences are poorly understood. Data from a random postal questionnaire survey in the Dutch general population were used to examine whether sex differences in the prevalences of CMP are due to sex differences in the distribution of known potential risk factors for CMP (exposure model) and/or to the different importance of risk factors for CMP (i.e. show different strength of association) in men and women (vulnerability model). In the present analyses, 909 men and 1178 women aged 25-65 were included. CMP was defined as pain lasting longer than 3 months and was assessed for 10 anatomical locations (neck, shoulder, higher back, elbow, wrist/hand, lower back, hip, knee, ankle, foot). Sex differences in CMP could not be explained by a different distribution of age, educational level, smoking status, overweight, physical activity, and pain catastrophizing. Having no paid job was associated with CMP, explaining part of the sex differences, but its role seems complex. Risk factors with a sex-specific association were: overweight (all pain locations) and older age (lower extremities)--both having only an effect among women--and pain catastrophizing (upper extremities), which was stronger associated with CMP among men than among women. In conclusion, sex differences in prevalence of CMP may partly be explained by sex differences in vulnerability to risk factors for CMP. Future research towards sex-specific identification of risk factors for CMP is warranted. Eventually this may lead to sex-specific prevention and management of CMP.
    • An exploration of socio-economic and food characteristics of high trans fatty acid consumers in the Dutch and UK national surveys after voluntary product reformulation.

      Rippin, H L; Hutchinson, J; Ocke, M; Jewell, J; Breda, J J; Cade, J E (2017)
      Trans fatty acids (TFA) increase the risk of mortality and chronic diseases. TFA intakes have fallen since reformulation, but may still be high in certain, vulnerable, groups. This paper investigates socio-economic and food consumption characteristics of high TFA consumers after voluntary reformulation in the Netherlands and UK. Post-reformulation data of adults aged 19-64 was analysed in two national surveys: the Dutch National Food Consumption Survey (DNFCS) collected 2007-2010 using 2*24hr recalls (N = 1933) and the UK National Diet and Nutrition Survey (NDNS) years 3&4 collected 2010/11 and 2011/12 using 4-day food diaries (N = 848). The socio-economic and food consumption characteristics of the top 10% and remaining 90% TFA consumers were compared. Means of continuous data were compared using t-tests and categorical data means using chi-squared tests. Multivariate logistic regression models indicated which socio-demographic variables were associated with high TFA consumption. In the Dutch analyses, women and those born outside the Netherlands were more likely to be top 10% TFA consumers than men and Dutch-born. In the UK unadjusted analyses there was no significant trend in socio-economic characteristics between high and lower TFA consumers, but there were regional differences in the multivariate logistic regression analyses. In the Netherlands, high TFA consumers were more likely to be consumers of cakes, buns & pastries; cream; and fried potato than the remaining 90%. Whereas in the UK, high TFA consumers were more likely to be consumers of lamb; cheese; and dairy desserts and lower crisps and savoury snack consumers. Some socio-demographic differences between high and lower TFA consumers were evident post-reformulation. High TFA consumers in the Dutch 2007-10 survey appeared more likely to obtain TFA from artificial sources than those in the UK survey. Further analyses using more up-to-date food composition databases may be needed.
    • An exploratory assessment of the preference for eHealth interventions to prevent HIV and sexually transmitted infections among men who have sex with men in Hanoi, Vietnam.

      Nguyen, Long Hoang; Nguyen, Huong Lan Thi; Larsson, Mattias; Tran, Bach Xuan; L Stein, Mart; Rocha, Luis E C; Strömdahl, Susanne (2020-09-11)
    • Exploring causality of the association between smoking and Parkinson's disease.

      Gallo, Valentina; Vineis, Paolo; Cancellieri, Mariagrazia; Chiodini, Paolo; Barker, Roger A; Brayne, Carol; Pearce, Neil; Vermeulen, Roel; Panico, Salvatore; Bueno-de-Mesquita, Bas; et al. (2018-11-20)
      The aim of this paper is to investigate the causality of the inverse association between cigarette smoking and Parkinson's disease (PD). The main suggested alternatives include a delaying effect of smoking, reverse causality or an unmeasured confounding related to a low-risk-taking personality trait. A total of 715 incident PD cases were ascertained in a cohort of 220 494 individuals from NeuroEPIC4PD, a prospective European population-based cohort study including 13 centres in eight countries. Smoking habits were recorded at recruitment. We analysed smoking status, duration, and intensity and exposure to passive smoking in relation to PD onset. Former smokers had a 20% decreased risk and current smokers a halved risk of developing PD compared with never smokers. Strong dose-response relationships with smoking intensity and duration were found. Hazard ratios (HRs) for smoking <20 years were 0.84 [95% confidence interval (CI) 0.67-1.07], 20-29 years 0.73 (95% CI 0.56-0.96) and >30 years 0.54 (95% CI 0.43-0.36) compared with never smokers. The proportional hazard assumption was verified, showing no change of risk over time, arguing against a delaying effect. Reverse causality was disproved by the consistency of dose-response relationships among former and current smokers. The inverse association between passive smoking and PD, HR 0.70 (95% CI 0.49-0.99) ruled out the effect of unmeasured confounding. These results are highly suggestive of a true causal link between smoking and PD, although it is not clear which is the chemical compound in cigarette smoking responsible for the biological effect.
    • Exploring determinants of hand hygiene compliance in LTCFs: a qualitative study using Flottorps' integrated checklist of determinants of practice.

      Lescure, Dominique; Haenen, Anja; de Greeff, Sabine; Voss, Andreas; Huis, Anita; Hulscher, Marlies (2021-01-14)
    • Exploring improvement plans of fourteen European integrated care sites for older people with complex needs.

      Stoop, Annerieke; De Bruin, Simone R; Wistow, Gerald; Billings, Jenny; Ruppe, Georg; Leichsenring, Kai; Obermann, Konrad; Baan, Caroline A; Nijpels, Giel (2019-09-24)
    • Exploring mechanisms underlying the relationship between the natural outdoor environment and health and well-being - Results from the PHENOTYPE project.

      Kruize, Hanneke; van Kamp, Irene; van den Berg, Magdalena; van Kempen, Elise; Wendel-Vos, Wanda; Ruijsbroek, Annemarie; Swart, Wim; Maas, Jolanda; Gidlow, Christopher; Smith, Graham; et al. (2019-10-31)
    • Exploring solutions for healthy, safe, and sustainable fatty acids (EPA and DHA) consumption in The Netherlands

      Hollander, A.; De Jonge, R.; Biesbroek, S.; Hoekstra, J.; Zijp, M. C. (2018-07-20)
    • Exploring the 'solution space' is key: SOLUTIONS recommends an early-stage assessment of options to protect and restore water quality against chemical pollution

      Posthuma, L; Backhaus, T; Hollender, J; Bunke, D; Brack, W; Muller, C; van Gils, J; Hollert, H; Muntje, J; van Wezel, A (2019-10-21)
    • Exploring the effect of previous inactivated influenza vaccination on seasonal influenza vaccine effectiveness against medically-attended influenza: results of the European I-MOVE multicentre test-negative case-control study, 2011/12-2016/17.

      Valenciano, Marta; Kissling, E; Larrauri, Amparo; Nunes, Baltasar; Pitigoi, Daniela; O Donnell, Joan; Reuss, Annicka; Horváth, Judit Krisztina; Paradowska-Stankiewicz, Iwona; Rizzo, Caterina; et al. (2018-04-16)
      Results of previous influenza vaccination effects on current season influenza vaccine effectiveness (VE) are inconsistent.
    • Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders.

      Martinelli, Thomas; Candel, Math J J M; de Vries, Hein; Talhout, Reinskje; Knapen, Vera; van Schayck, Constant P; Nagelhout, Gera E (2021-07-05)
      Studies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.
    • Exploring the Role of Farm Animals in Providing Care at Care Farms.

      Hassink, Jan; De Bruin, Simone R; Berget, Bente; Elings, Marjolein (2017-06-02)
      We explore the role of farm animals in providing care to different types of participants at care farms (e.g., youngsters with behavioural problems, people with severe mental problems and people with dementia). Care farms provide alternative and promising settings where people can interact with animals compared to a therapeutic healthcare setting. We performed a literature review, conducted focus group meetings and carried out secondary data-analysis of qualitative studies involving care farmers and different types of participants. We found that farm animals are important to many participants and have a large number of potential benefits. They can (i) provide meaningful day occupation; (ii) generate valued relationships; (iii) help people master tasks; (iv) provide opportunities for reciprocity; (v) can distract people from them problems; (vi) provide relaxation; (vii) facilitate customized care; (viii) facilitate relationships with other people; (ix) stimulate healthy behavior; (x) contribute to a welcoming environment; (xi) make it possible to experience basic elements of life; and (xii) provide opportunities for reflection and feedback. This shows the multi-facetted importance of interacting with animals on care farms. In this study the types of activities with animals and their value to different types of participants varied. Farm animals are an important element of the care farm environment that can address the care needs of different types of participants.
    • Exploring the Team Climate of Health and Social Care Professionals Implementing Integrated Care for Older People in Europe.

      MacInnes, Julie; Gadsby, Erica; Reynolds, Jillian; Mateu, Nuri Cayuelas; Lette, Manon; Ristl, Christina; Billings, Jenny (2020-10-19)
      Team climate describes shared perceptions of organisational policies, practices and procedures. A positive team climate has been linked to better interprofessional collaboration and quality of care. Most studies examine team climate within health or social care organisations. This study uniquely explores the team climate of integrated health and social care teams implementing integrated care initiatives for older people in thirteen sites across seven European countries, and examines the factors which contribute to the development of team climate.
    • Exploring uptake and biodistribution of polystyrene (nano)particles in zebrafish embryos at different developmental stages.

      van Pomeren, M; Brun, N R; Peijnenburg, W J G M; Vijver, M G (2017-09)
      In ecotoxicology, it is continuously questioned whether (nano)particle exposure results in particle uptake and subsequent biodistribution or if particles adsorb to the epithelial layer only. To contribute to answering this question, we investigated different uptake routes in zebrafish embryos and how they affect particle uptake into organs and within whole organisms. This is addressed by exposing three different life stages of the zebrafish embryo in order to cover the following exposure routes: via chorion and dermal exposure; dermal exposure; oral and dermal exposure. How different nanoparticle sizes affect uptake routes was assessed by using polystyrene particles of 25, 50, 250 and 700nm. In our experimental study, we showed that particle uptake in biota is restricted to oral exposure, whereas the dermal route resulted in adsorption to the epidermis and gills only. Ingestion followed by biodistribution was observed for the tested particles of 25 and 50nm. The particles spread through the body and eventually accumulated in specific organs and tissues such as the eyes. Particles larger than 50nm were predominantly adsorbed onto the intestinal tract and outer epidermis of zebrafish embryos. Embryos exposed to particles via both epidermis and intestine showed highest uptake and eventually accumulated particles in the eye, whereas uptake of particles via the chorion and epidermis resulted in marginal uptake. Organ uptake and internal distribution should be monitored more closely to provide more in depth information of the toxicity of particles.
    • Exploring Vector-Borne Disease Surveillance and Response Systems in Beijing, China: A Qualitative Study from the Health System Perspective.

      Lock-Wah-Hoon, Jerome; Zheng, Yang; Braks, Marieta; van Asten, Liselotte; Liu, Qiyong; Sushama, Preeti; Doreleijers, Simone; Krafft, Thomas; van der Hoek, Wim; Fanoy, Ewout; et al. (2020-11-17)
    • Exposure to Air Pollution during Pregnancy and Childhood, and White Matter Microstructure in Preadolescents.

      Lubczyńska, Małgorzata J; Muetzel, Ryan L; El Marroun, Hanan; Basagaña, Xavier; Strak, Maciej; Denault, William; Jaddoe, Vincent W V; Hillegers, Manon; Vernooij, Meike W; Hoek, Gerard; et al. (2020-02-01)
      We used data of 2,954 children from the Generation R Study, a population-based birth cohort from Rotterdam, Netherlands (2002-2006). Concentrations of 17 air pollutants including nitrogen oxides ( NO X ), particulate matter (PM), and components of PM were estimated at participants' homes during pregnancy and childhood using land-use regression models. Diffusion tensor images were obtained at child's 9-12 years of age, and fractional anisotropy (FA) and mean diffusivity (MD) were computed. We performed linear regressions adjusting for socioeconomic and lifestyle characteristics. Single-pollutant analyses were followed by multipollutant analyses using the Deletion/Substitution/Addition (DSA) algorithm.
    • Exposure to bacterial products lipopolysaccharide and flagellin and hepatocellular carcinoma: a nested case-control study.

      Fedirko, Veronika; Tran, Hao Quang; Gewirtz, Andrew T; Stepien, Magdalena; Trichopoulou, Antonia; Aleksandrova, Krasimira; Olsen, Anja; Tjønneland, Anne; Overvad, Kim; Carbonnel, Franck; et al. (2017-04-04)
      Leakage of bacterial products across the gut barrier may play a role in liver diseases which often precede the development of liver cancer. However, human studies, particularly from prospective settings, are lacking.
    • Exposure to Coxiella burnetii and risk of non-Hodgkin lymphoma: a retrospective population-based analysis in the Netherlands.

      van Roeden, Sonja E; van Houwelingen, Fedor; Donkers, Chiel M J; Hogewoning, Sander J; de Lange, Marit M A; van der Hoek, Wim; Kampschreur, Linda M; Bonten, Marc J M; Hoepelman, Andy I M; Bleeker-Rovers, Chantal P; et al. (2018-04-09)
      An association between Coxiella burnetii and non-Hodgkin lymphoma has been suggested. After a large Q fever epidemic in the Netherlands (2007-10), we postulated that the incidence of non-Hodgkin lymphoma would be increased during and after the epidemic in areas with a high endemicity of Q fever compared with those with low endemicity.