The platform for open and practice-oriented research

product

PRESchool@HealthyWeight: A Preschool-Based Intervention For Promoting Healthy Eating And Physical Activity In Toddlers

Background and aimsThe aim of this study was to gain insight in the effect of a preschool-based intervention for Early Childhood Education and Care (ECEC) teachers on promoting healthy eating and physical activity in toddlers.MethodsIn a cluster randomized controlled trial, 37 preschools of child care organization Impuls in Amsterdam Nieuw-West, the Netherlands, were randomly allocated to an intervention or control group. In total, 115 female ECEC teachers (mean age 42 ± 9 years) participated. The intervention for ECEC teachers consisted of two existing Dutch programs: ‘A Healthy Start’ and ‘PLAYgrounds’. The practices and knowledge of ECEC teachers concerning healthy eating and physical activity and the level of confidence in promoting healthy eating and physical activity in toddlers was assessed at baseline and 9 months of follow-up. To examine the effect of the intervention linear mixed models were used.ResultsPreliminary analyses of the practices indicated that Activity-related-Teaching/Autonomy-Support was increased in the intervention group (mean difference: 0.181), but not in the control group (mean difference: -0.048; p-value group*time: 0.025). Food-related-Pressure-to-Eat was decreased in the intervention group (mean difference: -0.580), but not in the control group (mean difference: -0.158; p-value group*time: 0.014). No effect of the intervention was found on knowledge (p-value group*time: 0.24) and the level of confidence (p-value group*time: 0.98) of ECEC teachers. ConclusionsThe preschool-based intervention seems to increase Activity-related-Teaching/Autonomy-Support and to decrease Food-related-Pressure-to-Eat. No effects were seen on knowledge and level of confidence of ECEC teachers in promoting healthy eating and physical activity in toddlers.

MULTIFILE

PRESchool@HealthyWeight: A Preschool-Based Intervention For Promoting Healthy Eating And Physical Activity In Toddlers

product

Tailor-made education with videos

Presentation at Dé Onderwijsdagen (SURF) in Utrecht

LINK

product

Development and evaluation of a fidelity tool in a post-discharge responsive parenting intervention program for very preterm born children

The TOP program is a fully implemented responsive parenting intervention for very preterm born infants. Fidelity monitoring of interventions is important for preserving program adherence, impact outcomes and to make evidence-based adaptations. The aim of this study was to develop a fidelity tool for the TOP program following an iterative and co-creative process and subsequently evaluate the reliability of the tool. Three consecutive phases were carried out. Phase I: Initial development and pilot testing two methods namely self-report and video based observation. Phase II: Adaptations and refinements. Phase III: Evaluation of the psychometric properties of the tool based on 20 intervention videos rated by three experts.The interrater reliability of the adherence and competence subscales was good (ICC.81 to .84) and varied from moderate to excellent for specific items (ICC between .51 and .98). The FITT displayed a high correlation (Spearman’s rho.79 to.82) between the subscales and total impression item. The co-creative and iterative process resulted in a clinical useful and reliable tool for evaluating fidelity in the TOP program. This study offers insights in the practical steps in the development of a fidelity assessment tool which can be used by other intervention developers.

MULTIFILE

Development and evaluation of a fidelity tool in a post-discharge responsive parenting intervention program for very preterm born children

product

Ethics, design, and creativity

In the context of the designers responsibility for the impact of technology, ethical considerations are important. However, these considerations are often seen as limiting innovation and the freedom of the designer. Is it possible, on the contrary, that ethics can also foster creativity in design? The research project Tech-Wise is about a practice oriented approach in ethics; developing tools to engage people with ethical deliberation on the impact of technology. One result of the project is a workshop format for stimulating ethical deliberation that can be tailored to particular technologies and design disciplines. We argue from the results of one particular instance of this workshop format that such an approach to ethics has a fruitful reciprocal effect. It can stimulate creativity in design by enriching the question about the purpose of an innovation, and the other way around enrich ethical reasoning by opening up to often surprising impacts of technologies.

MULTIFILE

product

The reliability of the neonatal oral-motor assessment scale

OBJECTIVES: Sucking problems in preterm infants can be specified by means of visual observation. The Neonatal Oral-Motor Assessment Scale (NOMAS) is the visual observation method most commonly used to assess the non-nutritive sucking (NNS) and nutritive sucking (NS) skills of infants up to approximately 8 weeks postterm. During the first 2 min of a regular feeding the infant's sucking skill is assessed, either immediately or on video. Although NOMAS has been used since 1993, little is known about the method's reliability. The aim of our study was to determine the test-retest and inter-rater reliability of NOMAS.METHODS: The 75 infants included in this study were born at 26-36 weeks postmenstrual age (PMA). Four observers participated in the study. They were trained and certified to administer NOMAS in the Netherlands by M.M. Palmer between 2000 and 2002.RESULTS: We found the test-retest agreement of NOMAS to be 'fair' to 'almost perfect' (Cohen's kappa [kappa] between 0.33 and 0.94), whereas the inter-rater agreement with respect to the diagnosis was 'moderate' to 'substantial' (Cohen's kappa, between 0.40 and 0.65). As a diagnostic tool, however, the current version of NOMAS cannot be used for both full-term and preterm infants. For a measuring instrument such as NOMAS, one should aim at reliability coefficients for inter-rater and test-retest agreement of at least 0.8. A Cohen's kappa of 0.6 or less we find unacceptable. Nonetheless, by observing sucking and swallowing according to a protocol much useful information can be gathered about the development of an infant's sucking skills. For instance, whether the infant is able to co-ordinate sucking and swallowing, whether the infant can maintain sucking, swallowing and breathing during the continuous phase and whether the infant is able to suck rhythmically with equally long bursts. In addition, NOMAS offers useful aids for intervention.CONCLUSIONS: NOMAS should be re-adjusted in order to improve inter-rater agreement, and at the same time current insights into the development of sucking and swallowing should be incorporated in the method.

PDF

product

Uncoordinated sucking patterns in preterm infants are associated with abnormal general movements

OBJECTIVE: To examine the association between sucking patterns and the quality of fidgety movements in preterm infants.STUDY DESIGN: We studied the sucking patterns and fidgety movements of 44 preterm infants (gestational age <35 weeks) longitudinally from 34 weeks' postmenstrual age up to 14 weeks postterm. We used the Neonatal Oral-Motor Assessment Scale during feeding and scored the sucking patterns as normal or abnormal. Abnormal sucking patterns were categorized into arrhythmic sucking and uncoordinated sucking. At 14 weeks postterm, we scored the quality of fidgety movements from videotapes as normal, abnormal, or absent.RESULTS: The postmenstrual age at which sucking patterns became normal (median, 48 weeks; range, 34 to >50 weeks) was correlated with the quality of fidgety movements (Spearman ρ = -0.33; P = .035). The percentage per infant of normal and uncoordinated sucking patterns was also correlated with the quality of fidgety movements (ρ = 0.31; P = .048 and ρ = -0.33; P = .032, respectively). Infants with uncoordinated sucking patterns had a higher rate of abnormal fidgety movements (OR, 7.5; 95% CI, 1.4-40; P = .019).CONCLUSION: The development of sucking patterns in preterm infants was related to the quality of fidgety movements. Uncoordinated sucking patterns were associated with abnormal fidgety movements, indicating that uncoordinated sucking, swallowing, and breathing may represent neurologic dysfunction.

PDF

product

Sucking behaviour in infants born preterm and developmental outcomes at primary school age

AIM: To determine the association between sucking in infants born preterm and developmental outcomes at 5 years.METHOD: Thirty-four infants were included (mean gestational age 30wks 4d, mean birthweight 1407g). The Neonatal Oral-Motor Assessment Scale was used longitudinally from 37 to 50 weeks postmenstrual age. At 5 years, we assessed motor skills, intelligence, language, verbal memory, and behavioural problems. Linear regression analyses were performed to test whether aspects of sucking behaviour predicted these developmental outcomes. Where linear regression was not appropriate, Spearman's correlation coefficients were calculated between sucking and developmental outcomes.RESULTS: Sucking was associated with total motor skills (B [unstandardized correlation coefficient for normally distributed data]=22.66, 95% confidence interval [CI] 6.61 to 38.71), balance (Spearman's ρ=0.64, p<0.001), total intelligence (B=-1.16, 95% CI -1.89 to -0.44, B=10.48, 95% CI 0.39 to 20.71, B=-2.22, 95% CI -3.42 to -1.02), verbal intelligence (B=-0.95; 95% CI -1.83 to -0.07, B=-2.02; 95% CI -3.55 to -0.49), performance intelligence (B=-1.34, 95% CI -2.13 to -0.54, B=12.36, 95% CI 1.13 to 23.60, B=-2.37, 95% CI -3.75 to -0.96), and language (B=-1.78, 95% CI -3.36 to -0.19). All associations were in the same direction: the better the sucking, the higher the test scores. Verbal memory and behavioural problems were not associated with sucking.INTERPRETATION: Abnormal sucking between 42 weeks and 50 weeks postmenstrual age may reflect abnormal neurological functioning in children born preterm.

PDF

product

Development of sucking patterns in preterm infants

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.

PDF

product

Association between sucking performance in preterm infants and developmental outcome at 2 and 5 years of age

Are sucking skills in a specific period (in weeks post menstrual age, PMA) associated with an abnormal development at age 2?Do preterm infants with abnormal sucking patterns in the early post term period differ in motor skills at age 5 from preterm infants with normal sucking patterns in the same early post term period?

PDF

Search results

Products 21

PRESchool@HealthyWeight: A Preschool-Based Intervention For Promoting Healthy Eating And Physical Activity In Toddlers

Tailor-made education with videos

Development and evaluation of a fidelity tool in a post-discharge responsive parenting intervention program for very preterm born children

Ethics, design, and creativity

The reliability of the neonatal oral-motor assessment scale

Uncoordinated sucking patterns in preterm infants are associated with abnormal general movements

Sucking behaviour in infants born preterm and developmental outcomes at primary school age

Development of sucking patterns in preterm infants

Association between sucking performance in preterm infants and developmental outcome at 2 and 5 years of age

Navigate to

Categories

Filters

Products 21

PRESchool@HealthyWeight: A Preschool-Based Intervention For Promoting Healthy Eating And Physical Activity In Toddlers

Tailor-made education with videos

Development and evaluation of a fidelity tool in a post-discharge responsive parenting intervention program for very preterm born children

Ethics, design, and creativity

The reliability of the neonatal oral-motor assessment scale

Uncoordinated sucking patterns in preterm infants are associated with abnormal general movements

Sucking behaviour in infants born preterm and developmental outcomes at primary school age

Development of sucking patterns in preterm infants

Association between sucking performance in preterm infants and developmental outcome at 2 and 5 years of age