Healthy gestational weight gain (GWG) is associated with better pregnancy outcomes and with improved health in the later lives of women and babies. In this thesis the author describes the process of developing an intervention to help pregnant women reach a healthy GWG. The need for this intervention was derived from discussions with midwives, working in primary care in the Netherlands. In this introduction, the author describes the background of the larger project “Promoting Health Pregnancy”, of which this study is a part (1.2), the problem of unhealthy GWG (1.3-1.6) and offers a brief introduction to the theoretical framework of the study and to the subsequent chapters (1.7-1.9).
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Objective: Gaining too much or too little weight in pregnancy (according to Institute of Medicine (IOM) guidelines) negatively affects both mother and child, but many women find it difficult to manage their gestational weight gain (GWG). Here we describe the use of the intervention mapping protocol to design ‘Come On!’, an intervention to promote adequate GWG among healthy pregnant women. Design: We used the six steps of intervention mapping: (i) needs assessment; (ii) formulation of change objectives; (iii) selection of theory-based methods and practical strategies; (iv) development of the intervention programme; (v) development of an adoption and implementation plan; and (vi) development of an evaluation plan. A consortium of users and related professionals guided the process of development. Results: As a result of the needs assessment, two goals for the intervention were formulated: (i) helping healthy pregnant women to stay within the IOM guidelines for GWG; and (ii) getting midwives to adequately support the efforts of healthy pregnant women to gain weight within the IOM guidelines. To reach these goals, change objectives and determinants influencing the change objectives were formulated. Theories used were the Transtheoretical Model, Social Cognitive Theory and the Elaboration Likelihood Model. Practical strategies to use the theories were the foundation for the development of ‘Come On!’, a comprehensive programme that included a tailored Internet programme for pregnant women, training for midwives, an information card for midwives, and a scheduled discussion between the midwife and the pregnant woman during pregnancy. The programme was pre-tested and evaluated in an effect study.
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Unhealthy gestational weight gain (GWG) contributes to long-term obesity in women and their offspring. The aim of this study is to quantify midwives’ behavior in promoting healthy GWG and to identify the most important determinants related to this behavior.
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In de voorschool worden pedagogisch medewerkers (PMers) steeds vaker geconfronteerd met overgewicht bij kinderen van 2,5 tot 4 jaar. De PMer is getraind in het ondersteunen van de ontwikkeling en opvoeding van het kind. PMers zijn niet opgeleid voor leefstijladvisering. Ongezonde voeding en inactiviteit zijn de belangrijkste oorzaken van overgewicht. Overgewicht komt op jonge leeftijd al meer voor bij lagere sociaaleconomische en etnische groepen. De gezondheidsverschillen nemen hierdoor toe. PMers geven aan dat zij zich niet bekwaam voelen om verantwoordelijk te zijn voor de gezonde keuzes op de voorschool als ook in de advisering naar ouders toe. De centrale vragen in dit project zijn: Wat heeft de PMer in de voorschool nodig in kennis, vaardigheden en attitude om het handelingsrepertoire tav leefstijladvisering aan alle kinderen van 2,5 tot 4 jaar en ouders met diverse sociaaleconomische en cultureel-etnische achtergronden te professionaliseren. Wat is het effect van het handelen van de PMer op de gezonde (gewichts)ontwikkeling van het kind? Het onderzoek is een gerichte interventiestudie met voor- en nametingen bij PMers, kinderen en ouders. De interventie wordt bij een deel van de PMers uitgevoerd en vergeleken met een controlegroep. Bij kinderen worden fysieke- en gedragsmetingen uitgevoerd. Eindpunten zijn het vertrouwen in leefstijladvisering door PMers en ontwikkelingstrends in gewicht bij kinderen. Fases van het projectplan: I. nulmeting en interventie bij PMers; II. nulmeting bij kinderen en interventie door PMers; III. effectmeting interventie bij PMers en kinderen; IV. ontwikkeling competentieprofiel leefstijladvisering voor PMers. Het PS@HW consortium olv de Hogeschool van Amsterdam, Impuls Kinderopvang, Brancheorganisatie Kinderopvang Amsterdam, Nederlands Jeugdinstituut, RIVM Centrum voor Gezond Leven, VU medisch centrum, HvA-Speerpunt Urban Vitality en Sarphati Amsterdam pakt dit op. Dit project beoogt het ontwikkelen van de HBO competentie leefstijladvisering voor PMers van de voorscholen die kinderen bereiken met een achterstand, voor een gezonde (gewichts)ontwikkeling en het terugdringen van gezondheidsverschillen.
Thermoset materials find use in almost all industrial sectors, especially where lightweight, stiffness, resistance and dimensional stability are key performance requirements. However, traditional thermosets suffer from several drawbacks: they are made of fossil-based non-reversible polymers and toxic monomers; more importantly, thermosetting materials are virtually neither recyclable nor reprocessable, due to their crosslinked microstructure. Currently, most thermoset materials are incinerated or accumulated in landfills at the end of their life. Landfill waste degrades to liquids known as landfill leachates that lead to health and environmental problems. A significant part of these wastes originate from thermoset materials used in paints, coatings, sealants and adhesives applied as a thin film to all sorts of surfaces. These unrecyclable materials contribute to nano- and microplastic formation. Despite many efforts in the past years in this context, substantial further developments are required. Production of thermosets from biobased feedstocks using safe and sustainable-by-design approaches is therefore crucial to address the well-being of people and to have a healthy planet.SMARTCASE aims to develop safe and circular carbohydrate-derived reactive polyester resins for coatings, adhesives, sealants and elastomers for application in the building and interior sectors. The new two-component (‘2K’) formulations are designed to replace currently used fossil-based epoxy and urethane resins by biobased and GHS-label-friendly alternatives. This not only improves the safety of workers and end-users of these materials, but also reduces the dependency on fossil resources and facilitates the transition towards abundantly available biobased raw materials.A new class of biobased polyesters resins and thermosets will be designed in SMARTCASE using safe and sustainable by design approaches allowing for more sustainable and feasible end-of-life options. Biobased polyesters in general meet the requirements of circularity, as they can be efficiently recycled back to their monomers at end-of-life. Accordingly, the recycling and degradation behavior of the developed formulations under thermal, mechanical and chemical conditions and their biodegradation will be studied. Hence, the output of the project contributes to the main goals of the NGF BioBased Circular program.The project follows a value-cycle approach with a multi-disciplinary and balanced consortium of industrial representatives from every part of the value chain, from carbohydrate feedstock suppliers to resin formulators and end users. This enables a system innovation instead of a (single) product innovation. The following results are expected within 10 years (mostly by the end of the project ): - Sustainable feedstock platform for novel biobased (BB) platform chemicals- Access to novel monomers and building blocks- Access to safe and novel polyester-based resin components- Access to high performance, safe and circular thermoset formulations- Scale-up of the best thermoset formulations- Validated performance of novel thermoset formulations in industrial applications- Sustainable and circular-by-design thermoset formulations with defined end-of-life solutions - Data on LCA, TEA, toxicity and sustainability- Engaged stakeholders and effective dissemination of project outcomes By ensuring these results are implemented by industrial partners both during and after the project, they will benefit not only stakeholders, chemical industries, and consortium partners but also the general public.
