Background: Healthy development of children is under pressure. While governments, schools and organizations are trying to stimulate physical activity in children, reduce overweight and improve motor skills, they are facing challenges in finding effective strategies. The model proposed by Stodden et al. (2008) is an interesting framework for studying healthy development of children, as it encompasses the physical aspect (motor skill competence, physical fitness, weight status), the mental aspect (perceived competence) and a behavioral component (physical activity). Importantly, it acknowledges the developmental stages of children by including age. Therefore, this model serves as the basis for this study in which we are looking for insights to effectively influence healthy development of children. Methods and Results: We measured these five variables in a large sample (N > 1000) of children in the Netherlands (age: 4-12, 50% girls). Through structural equation modeling we searched for cross-sectional as well as 1-year longitudinal relationships. Our results showed concurrent relationships between all variables and a tipping point at which relationships emerged or strengthened. The results indicated that targeting motor competence at a young age might be a feasible way to ensure continued participation in physical activities. However, longitudinal analyses revealed no effect of motor skill competence (T1) on physical activity (T2). Physical fitness appeared to be more important as a potential mediator than perceived motor competence. As a follow-up study, the five variables will be analyzed via a person-centered approach (latent profile analyses). This will guide us towards tailoring future interventions to the specific needs of subgroups of children. Analyses of this study are ongoing and will be presented at the conference. Conclusions: Our multiple analyses have shed additional light on the complexity of healthy development of children. In the upcoming presentation we will unite our study findings and delineate implications for developing effective strategies.
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Inleiding: Bij mensen met verstandelijke beperkingen (VB) is obstipatie een van de meest voorkomende gezondheidsproblemen en de gevolgen kunnen groot zijn. Dit onderzoek beoogt een overzicht te geven van de prevalentie van, risicofactoren voor en (niet-)medicamenteuze behandeling van obstipatie bij mensen met VB. Daarnaast wordt de relatie tussen obstipatie, dysfagie en medicatie geanalyseerd.Methode: Het onderzoek bestond uit literatuur- en dossieronderzoek. Voor het systematische literatuuronderzoek werden de databases PubMed en Scopus doorzocht. Het dwarsdoorsnede (cross-sectionele) dossieronderzoek werd uitgevoerd bij zorginstelling Alliade. Data over aanwezigheid van obstipatie, laxantiagebruik, inzet van niet-medicamenteuze behandelingen en risicofactoren, waaronder dysfagie en medicatiegebruik, werden verzameld.Resultaten: De literatuur toonde sterk variërende obstipatie-prevalenties van 6 tot 94%. Het dossieronderzoek liet zien dat 24,3% van de cliënten een obstipatiediagnose heeft en 55% chronisch laxantia gebruikt. Risicofactoren voor obstipatie werden in de literatuur weinig gevonden. Risicofactoren gevonden in de dossiers waren mate VB, dysfagie en medicatie. Niet-medicamenteuze behandelingen voor obstipatie werden zelden gerapporteerd en betroffen fysiotherapeutische behandelingen, buikmassage en voedingssupplementen. Conclusie: De prevalentie van obstipatie en chronisch laxantiagebruik bleek hoog. Er is nog veel onduidelijk over risicofactoren en over de inzet van alternatieve behandelmethoden naast laxantia. Gezien de grote impact die obstipatie kan hebben op mensen met VB is verder onderzoek naar deze aandoening en de behandelmethoden wenselijk.
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The studies reported on in this thesis addressed the development of suckingpatterns in preterm newborns. Preterm infants often have problems learningto suckle at the breast or to drink from a bottle. It is unclear whether this isdue to their preterm birth or whether it is the consequence of neurologicaldamage. From the literature, as well as from daily practice, we know thatthere is much variation in the time and in the way children start suckingnormally. Factors such as birth weight and gestational age may indeed berisk factors but they do not explain the differences in development. A smallspot-check proved that most hospitals in the Netherlands start infants onoral feeding by 34 weeks’ post-menstrual age (pma). By and large the policyis aimed at getting the infant to rely on oral feeding entirely as soon aspossible. The underlying rationale is to reduce the stay in hospital, and theidea that prolonged tube-feeding delays or even hampers the development ofsucking.
