showing 31 related works from this author
Colorectal cancer stage at diagnosis in migrants versus non-migrants (KoMigra) : study protocol of a cross-sectional study in Germany
2014
Background: In Germany, about 20% of the total population have a migration background. Differences exist between migrants and non-migrants in terms of health care access and utilisation. Colorectal cancer is the second most common malignant tumour in Germany, and incidence, staging and survival chances depend, amongst other things, on ethnicity and lifestyle. The current study investigates whether stage at diagnosis differs between migrants and non-migrants with colorectal cancer in an area of high migration and attempts to identify factors that can explain any differences. Methods/Design: Data on tumour and migration status will be collected for 1,200 consecutive patients that have receive…
Returns to Childbirth Technologies: Evidence from Preterm Births
2013
We investigate the impact of obstetrician supervision, as opposed to midwife supervision, on the short-term health of low-risk newborns. We exploit a unique policy rule in the Netherlands that creates a large discontinuity in the probability of a low-risk birth being attended by an obstetrician at gestational week 37. Using a fuzzy regression discontinuity design, we consistently find no health benefits from obstetrician supervision, despite increased rates of neonatal intensive care unit admissions among births supervised by obstetricians. These results indicate potential cost savings from increased use of midwifery care for low-risk deliveries.
Tumor biology in older breast cancer patients – What is the impact on survival stratified for guideline adherence? A retrospective multi-centre cohor…
2015
Abstract Purpose The tumor biology of older breast cancer patients (oBCP) is usually less aggressive, however applied adjuvant treatment is often less potent resulting in an impaired disease free survival and overall survival in this group. This study tries to answer the following questions for the biological subtypes of oBCP (70+ y): (1) Is there a significant difference in the distribution of the biological subtypes of oBCP vs younger breast cancer patients (yBCP; 50–69 y)? (2) Which biological subtype has the highest rate of non-guideline-adherent-treatment (GL−) among oBCP? (3) Is a single GL− (i.e. radiotherapy/surgery/endocrine-therapy/chemotherapy) significantly associated with the s…
Babies of the War: Effect of War Exposure Early in Life on Mortality Throughout Life
2015
There is increasing evidence that circumstances very early in our lives, and particularly during pregnancy, can affect our health for the remainder of life. Studies that have looked at this relationship have often used extreme situations, such as famines that occurred during wartime. Here we investigate whether less extreme situations during World War II also affected later-life mortality for cohorts born in Belgium, France, The Netherlands, and Norway. We argue that these occupied countries experienced a considerable deterioration in daily life situations and show that this resulted in strongly increased mortality rates and lower probabilities of survival until age 55 among civilian popula…
Gender Peer Effects in University: Evidence from a Randomized Experiment
2010
Recent studies for primary and secondary education find positive effects of the share of girls in the classroom on achievement of boys and girls. This study examines whether these results can be extrapolated to post-secondary education. We conduct an experiment in which the shares of girls in workgroups for first year students in economics and business are manipulated and students are randomly assigned to these groups. Boys tend to postpone their dropout decision when surrounded by more girls, and there is also a modest reduction in early absenteeism. On the other hand, boys perform worse on courses with high math content when assigned to a group with many girls. Overall, however, we fail t…
Fasting During Pregnancy and Children's Academic Performance
2011
Conventionally studied educational interventions tend to be costly and may be subject to “fade out”. In contrast, experiences during the prenatal period can have large and persistent effects on academic performance, even when quite brief. In this paper, we consider a relatively mild and commonly-experienced prenatal exposure – that occasioned by daytime fasting during the lunar month of Ramadan. In register data from England, we find that test scores at age seven are approximately .05 to .08 standard deviations lower for Pakistani and Bangladeshi students exposed to Ramadan in early pregnancy. We argue these “intent to treat” estimates are downward biased relative to fasting’s effect due to…
Disease Burden of Rotavirus Gastroenteritis in Children Residing in Germany: A Retrospective, Hospital-based Surveillance.
2015
Background Representative, population-based epidemiologic data for gastroenteritis caused by rotavirus (RV) are rare. RV vaccines were first licensed in Europe in 2006 and recommended in 5 western federal states in 2008 or thereafter. This study establishes a baseline for assessing the impact of vaccination and delineates the RV disease burden in Germany today. Methods Nationwide data obtained from hospitals for children 0 to 10 years of age and transferred to the Federal Statistical Office were analyzed retrospectively. Acute gastroenteritis cases because of RV were identified by the International Classification of Diseases code (ICD-10) combined with the referring diagnosis-related group …
Peer ethnicity and achievement: a meta-analysis into the compositional effect
2010
This study reports a meta-analysis on the effects of ethnic minority share in school on achievement test scores. Best evidence from the studies that have appeared thus far on this topic shows that these compositional effects appear small in general, but may be larger when the ethnic minority group is African Americans in the USA, than when the minority group consists of immigrants. A high share of students from an ethnic minority group seems to affect the achievement from students belonging to the same ethnic group more, than the achievement of students belonging to the ethnic majority or to other ethnic minority groups. Effects of the share of immigrants on test scores of ethnic majority s…
Why People Born During World War II are Healthier
2017
War leads civilians to suffer. This can take extreme forms, such as during periods of intense violence or famines. But also outside of such episodes, civilians’ lives during wars can be harsh, as they suffer from poorer nutritional situations, stress, recessions, and sub optimally functioning health care systems. The more extreme types of suffering are proven to lead to a worse health among those prenatally exposed to them. But long-run effects of prenatal exposure to the latter circumstances have thus far largely been unexplored, even though in many wars more pregnant women are exposed to these “everyday” circumstances than to the extreme circumstances. We study the general, population-wid…
Aggressive Intrinsic Subtypes in Breast Cancer: A Predictor of Guideline Adherence in Older Patients With Breast Cancer?
2015
Treatment side effects, comorbidities, and guideline-adherent treatment (GL+) influence the oncologic outcome of older breast cancer patients (oBCP) (age ≥ 70 years). The focus of this analysis was to investigate the associations among tumor characteristics, guideline adherence, and outcome and to compare these associations between younger breast cancer patients (yBCP) (age 50-69 years) and oBCP.This is a retrospective multicenter cohort study with 17 participating certified breast cancer centers. The analysis of 10,897 patient records collected from 1992 to 2008 for GL+ and clinical outcome was performed. Tumor and patient characteristics and their associations with GL+ were compared betwe…
Assessing the impact of CMF/FEC/FEC-DOC/ETC (dose-dense) adjuvant chemotherapy in dependency of positive axillary lymph nodes on survival: A retrospe…
2013
1074 Background: Adjuvant chemotherapy has changed dramatically in the last decades. Anthracycline-/taxane-based and dose-dense chemotherapy regimens improved survival in node positive breast cancer. This study tries to answer the following questions: (1) Are there differences in survival dependent on chemotherapy regimens in 0/0-3/4-10/<10 positive lymph nodes? (2) Is it possible to define a cut-off of positive lymph nodes for the use of Taxane-based and dose dense chemotherapy? Methods: This German is a multi-center [17 participating hospitals all are certified as breast cancer centers] retrospective cohort study. We included CMF (1.385), FEC (1.170), FEC-DOC (1.723), and dose-dense E…
Ramadan During Pregnancy – Fasting, Nutrition, Sleep Patterns and Offspring Health at Birth: A Cross-Sectional Study
2020
Background: Intrauterine exposure to Ramadan is associated with adverse offspring health outcomes. Yet, the dynamics behind these associations remain largely unexplored. We investigate if maternal intermittent fasting or other lifestyle changes during Ramadan affect birth outcomes, and determine whether nutritional and sleep behavior during non-fasting hours influences the fasting-birth weight association. Methods: Linear regressions are estimated using OLS to identify the associations between fasting, sleep behavior, sweets consumption and birth weight, 5-minute APGAR score and gestational age. Interaction terms between fasting and other behaviors are included to explore the potential mode…
Participation in adjuvant clinical breast cancer trials: Is there a difference in survival compared to guideline adherent adjuvant treatment? A retro…
2012
1082 Background: Clinical trials (CT) usually compare a standard treatment regime versus innovative new substances or regimens. However participation in CT is available for only few patients and exclusion criteria is usually very strict. Therefore this study tries to answer the following questions: (1) Does participation in adjuvant CT improve survival in breast cancer (BC)? (2) Is there a difference in survival compared to guideline adherence and what is the role of the other treatments surrounding adjuvant breast cancer treatment? Methods: This German multi-center [17 participating hospitals all are certified as breast cancer centers] retrospective cohort study called BRENDA (BRENDA = qu…
Ramadan Exposure In Utero and Child Mortality in Burkina Faso: Analysis of a Population-Based Cohort Including 41,025 Children.
2017
Ramadan exposure in utero can be regarded as a natural experiment with which to study how nutritional conditions in utero influence susceptibility to disease later in life. We analyzed data from rural Burkina Faso on 41,025 children born between 1993 and 2012, of whom 25,093 were born to Muslim mothers. Ramadan exposure was assigned on the basis of overlap between Ramadan dates and gestation, creating 7 exclusive categories. We used proportional hazards regression with difference-in-differences analysis to estimate the association between Ramadan exposure at different gestational ages and mortality among children under 5 years of age. Under-5 mortality was 32 deaths per 1,000 child-years. U…
Van Ewijk et al. respond to "Ramadan prenatal fasting and adult health outcomes"
2013
Low-risk isn’t no-risk: Perinatal treatments and the health of low-income newborns
2019
We investigate the effects of perinatal medical treatments on low-income newborns who are classified as low-risk. A policy rule in The Netherlands states that low-risk deliveries before week 37 should be supervised by physicians and later deliveries only by midwives with no physician present. This creates large discontinuities in the probability of receiving medical interventions only physicians are allowed to perform. Using a regression discontinuity design, we find that babies born slightly before the week-37 cutoff are significantly less likely to die than babies born slightly later. Our data suggest that physician supervision of birth reduces the likelihood of adverse events such as fet…
The course of psychiatric co-morbidity in patients with breast cancer - results from the prospective multi-centre BRENDA II study
2015
Purpose This study examined the frequency of psychiatric co-morbidity in patients with breast cancer, its changes over time and predictors for these changes. Methods In a prospective study with measurements before surgery (t1, baseline), 1 month (t2) and 8 months thereafter (t3) using the Patient Health Questionnaire, we examined the course of psychiatric co-morbidity in breast cancer patients. The co-morbidity courses were grouped into healthy (no co-morbidity during the study), acute (co-morbidity at t1 and/or t2, but not at t3), emerging (no co-morbidity at t1, but at t3) and chronic (co-morbidity at t1 and t3). Results Of the 598 participants, 19% had acute, 10% emerging and 9% chronic …
Ramadan exposure and birth outcomes: a population-based study from the Netherlands.
2020
AbstractBackground:Ramadan, the Islamic month of daytime fasting, is observed by many pregnant Muslims. Although pregnant women are exempt, many prefer to fast. Previous research has shown long-term adverse effects on various health outcomes among the offspring, but evidence on effects on perinatal outcomes is mixed. This study investigates effects of Ramadan during pregnancy among Muslims in the Netherlands.Methods:Data from the Perinatal Registry of the Netherlands (Perined) on all births between 2000 and 2010 to mothers recorded as Mediterranean (i.e. of Turkish/Moroccan descent, a proxy for Muslim) (n = 139,322) or as ethnically Dutch (n = 1,481,435) were used. Ramadan exposure was defi…
As Long as the Breath Lasts: In Utero Exposure to Ramadan and the Occurrence of Wheezing in Adulthood.
2017
While prenatal exposure to Ramadan has been shown to be negatively associated with general physical and mental health, studies on specific organs remain scarce. In this study, we explored whether Ramadan exposure during pregnancy affects the occurrence of wheezing, a main symptom of obstructive airway disease. Using data from the Indonesian Family Life Survey collected between 1997 and 2008 (waves 2-4), we compared wheezing occurrence among adult Muslims who had been in utero during Ramadan with that in adult Muslims who had not been in utero during Ramadan. Wheezing prevalence was higher among adult Muslims who had been in utero during Ramadan, independent of the pregnancy phase in which t…
Early life conditions and later life inequality in health
2013
Abstract Prenatal exposure to adverse conditions is known to affect health throughout the life span. It has also been shown that health is unevenly distributed at advanced ages. This chapter investigates whether health inequalities at old age may be partially caused by prenatal circumstances. We use a sample of people aged 71–91 from eight European countries and assess how shocks in GDP that occurred while the respondents were still in utero affect four important dimensions of later-life health: cognition, depression, functional limitations, and grip strength. We find that early-life macro-economic circumstances do not affect health at advanced ages, nor do they affect inequalities in healt…
Is guideline-adherent adjuvant treatment an equivalent option for elderly patients who cannot participate in adjuvant clinical breast cancer trials? …
2014
1063 Background: It is well accepted that innovation in oncology is transported through randomized clinical trials (CT). However, elderly patients (>65) are usually excluded from CT. Therefore this...
The effect of peer socioeconomic status on student achievement: a meta-analysis
2010
Previous studies on the effects on students’ test scores of their peers’ socioeconomic status (SES) have reported varying results. In order to understand why researchers have alternately found small effects, large effects, or no effects at all, a meta-regression analysis including an extensive database of 30 studies on the topic was conducted. Results show that the size of the compositional effect that researchers find is strongly related to how they measure SES and to their choice of model. Measuring SES dichotomously (e.g. free lunch eligibility) or including several average SES variables in one model leads to smaller effect estimates than using a thoroughly constructed composite that inc…
Saving Lives at Birth: The Impact of Home Births on Infant Outcomes
2012
Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for endogeneity in location of birth, we exploit the exogenous variation in distance from a mother’s residence to the closest hospital. We find that giving birth in a hospital leads to substantial reductions in newborn mortality. We provide suggestive evidence that proximity to medical technologies may be an important channel contributing to these health gains.
Which patient- and physician-related factors influence guideline adherence in adjuvant endocrine therapy?: Results of the prospective multi-center co…
2015
e11544 Background: This study examined the question, which factors influence patients’ and physicians’ decisions associated with guideline adherent adjuvant endocrine therapy (ET). Methods: In a pr...
Gabrysch and van Ewijk Respond to “Detrimental Consequences of Adverse Early-Life Conditions” and “Ramadan, Pregnancy, Nutrition, and Epidemiology”
2018
In UteroRamadan Exposure and Children's Academic Performance
2014
A large literature has linked the in utero environment to health in adulthood. We consider how prenatal nutrition may shape human capital acquisition in childhood, utilising the month-long Ramadan fast as a natural experiment. In student register data for Pakistani and Bangladeshi families in England, we examine whether Ramadan's overlap with pregnancy affects subsequent academic outcomes at age 7. We find that test scores are 0.05-0.08 standard deviations lower for students exposed to Ramadan in early pregnancy. Our results suggest that brief prenatal investments may be more cost effective than traditional educational interventions in improving academic performance.
Same work, lower grade? Student ethnicity and teachers’ subjective assessments
2010
Previous research shows that ethnic minority students perform poorer in school when they are taught by ethnic majority teachers. Why this is the case was unclear. This paper focuses on one important potential explanation: I examine whether ethnic majority teachers grade minority and majority students differently for the same work. Using an experiment, I rule out the existence of such a direct grading bias. I do find indirect evidence for alternative explanations: teachers report lower expectations and unfavorable attitudes that both likely affect their behavior towards minority students, potentially inducing them to perform below their ability level. Effects of having majority teachers on m…
Long-term health effects on the next generation of Ramadan fasting during pregnancy
2011
Each year, many pregnant women fast from dawn to sunset during the Islamic holy month of Ramadan. Medical theory suggests that this may have negative long-term health effects on their offspring. Building upon the work of Almond and Mazumder (2008), and using Indonesian crosssectional data, I show that people who were exposed to Ramadan fasting during their mother's pregnancy have a poorer general health and are sick more often than people who were not exposed. This effect is especially pronounced among older people, who, when exposed, also report health problems more often that are indicative of coronary heart problems and type 2 diabetes. The exposed are a bit smaller in body size and weig…
Ramadan fasting and newborn's birth weight in pregnant Muslim women in The Netherlands.
2014
Many Muslim women worldwide are pregnant during Ramadan and adhere to Ramadan fasting during pregnancy. In the present study, we determined whether maternal adherence to Ramadan fasting during pregnancy has an impact on the birth weight of the newborn, and whether the effects differed according to trimester in which Ramadan fasting took place. A prospective cohort study was conducted in 130 pregnant Muslim women who attended antenatal care in Amsterdam and Zaanstad, The Netherlands. Data on adherence to Ramadan fasting during pregnancy and demographics were self-reported by pregnant women, and the outcome of the newborn was retrieved from medical records after delivery. The results showed t…
Ramadan Observance during Pregnancy in Germany: a Challenge for Prenatal Care.
2018
Abstract Introduction Fasting during Ramadan while pregnant has been shown to have long-term negative effects on the offspringʼs physical and cognitive health. Even though most Muslims do not believe pregnant women are obligated to fast during Ramadan, fasting rates of up to 87% have been reported for pregnant women. No data exists to date about Ramadan adherence and behavior in Germany. Methods The Mainz Study of Ramadan and Pregnancy surveyed pregnant Muslims and new Muslim mothers in Mainz between October 2016 and January 2017 and collected information on Ramadan adherence and behavior. We also collected data on personal characteristics and opinions, to identify determinants of fasting u…
Human CD8+ memory and EBV-specific T cells show low alloreactivity in vitro and in CD34+ stem cell–engrafted NOD/SCID/IL-2Rγcnull mice
2013
Current strategies in cellular immunotherapy of cancer and viral infections include the adoptive transfer of T cell receptor (TCR) and chimeric antigen receptor engineered T cells. When using transient RNA expression systems in clinical studies, multiple infusions with receptor-redirected T cells appear necessary. However, in allogeneic hematopoietic stem-cell transplantation, repeated transfer of donor-derived T cells increases the risk of alloreactive graft-versus-host disease. We investigated naive-derived (T N ), memory-derived (T M ), and Epstein Barr virus-specific (T EBV ) CD8 + T cell subsets for alloreactivity upon redirection with RNA encoding a cytomegalovirus-specific model TCR.…