This thesis focuses on topics such as preterm birth, variation in gross motor development, factors that influence (premature) infant gross motor development, and parental beliefs and practices. By gaining insight into these topics, this thesis aims to contribute to clinical decision-making of paediatric physiotherapists together with parents, and with that shape early intervention.
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ObjectiveTo obtain insights into parents' information needs during the first year at home with their very preterm (VP) born infant.MethodsWe conducted semi-structured interviews with parents of VP infants participating in a post-discharge responsive parenting intervention (TOP program). Online interviews were audiotaped and transcribed verbatim. Inductive thematic analysis was performed by two independent coders.ResultsTen participants were interviewed and had various and changing information needs during the developmental trajectory of their infant. Three main themes emerged; (1) Help me understand and cope, (2) Be fully responsible for my baby, and (3) Teach me to do it myself. Available and used sources, such as the Internet, did not meet their information needs. Participants preferred their available and knowledgeable healthcare professionals for reassurance, tailored information, and practical guidance.ConclusionThis study identified parents' information needs during the first year at home with their VP infant and uncovered underlying re-appearing needs to gain confidence in child-caring abilities and autonomy in decision-making about their infants' care.InnovationThis study provides valuable information for healthcare professionals and eHealth developers to support parental self-efficacy during the first year after preterm birth.
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The years between 1900 and 1930 have been a crucial period for the formation of large organizations in the Western world. Managers and scholars were searching for appropriate business models given the institutional setting. This model has impacted (and still does) the way we look at organizations and organizational change. At the time, however, this enterprise concept was not a triviality or taken for granted. Also contemporary business historians are careful to explain its rise. The purpose of our study is to readdress the issue of the birth of an organization. We find that that the application of different theoretical angles hampers the comparability of the starting point and alternatives routes of organizations. This leaves the question open when we generally can speak of a new organization and gives us the opportunity to critically assess the reference to the dominant business model of the 20th century, namely the multi-divisional enterprise
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Dit document geeft middels ontwerprichtlijnen antwoord op de vraag; “Op wat voor manier kunnen ouders van het ToP programma digitaal ondersteund worden door zorgprofessionals om (thuis) zelfstandig (betrouwbare) informatie te vinden die helpt bij het begeleiden van de ontwikkeling van hun prematuur geboren kind?” Voor het beantwoorden van deze vraag zijn interviews en focusgroepen gehouden met zorgprofessionals en ouders. Deze interviews zijn geanalyseerd en verwerkt tot ontwerprichtlijnen van een systeem dat ouders kan ondersteunen in het zelfstandig vinden van betrouwbare informatie. De ontwerprichtlijnen bestaan uit een doelgroepomschrijving, lijst van eisen, systeem diagram en interface concepten.Behoefte InventarisatieOm informatie over de behoeftes en mogelijkheden voor een informatieplatform te verzamelen zijn interviews afgenomen met ouders en professionals die participeren in het ToP programma. Er zijn twee focusgroepen met totaal 13 professionals en 10 interviews met ouders gehouden. Hieruit is naar voren gekomen dat er vraag is naar gepersonaliseerde informatie betreffende het prematuur geboren kind. Denk hierbij aan gedoseerde afgifte van informatie, en informatie over specifieke complicaties of aandoeningen dat het prematuur geboren kind zou kunnen hebben. Ouders komen nu vaak bij informatie terecht die niet relevant of toepasbaar is voor hun kind en situatie. Uit ons onderzoek bleek dat ouders en professionals behoefte hebben aan een (online) applicatie als aanvulling op het ToP programma. Deze applicatie zal moeten aangeven in wat voor ontwikkelingsfase het kind zich bevindt; zal rekening moeten houden met de tijdsverloop van de ontwikkeling van het prematuur geboren kind; en zal deelbare informatie moeten bevatten voor de sociale omgeving, zoals grootouders.OntwerprichtlijnenNa het analyseren van de behoeftes zijn er ontwerprichtlijnen opgesteld voor een te realiseren informatieplatform. De richtlijnen bestaan uit een doelgroepomschrijving, lijst van eisen en conceptuele vormgeving.Om op maat informatie aan te bieden aan ouders in verschillende situaties en achtergronden (zoals ouders die moeite hebben met de Nederlandse taal), dient informatie bij voorkeur beschikbaar zijn in verschillende media type, denk hierbij aan tekst, audio, video, animatie en schematische weergaven. De betrouwbaarheid van de informatie moet aangegeven zijn middels bronvermelding. Verder moet de informatie gemakkelijk doorzoekbaar zijn via een zoekfunctie dat gebruik maakt van tagging. Er zijn verschillende gebruikersinterfaces voorgesteld, die informatie beter inzichtelijk en doorzoekbaar moeten maken. De concepten zijn: een document structuur, fase structuur en visuele structuur.Het platform dient beschikbaar te zijn als: smartphone app (Android en iPhone) en website. De interface is toegankelijk en sluit aan bij bekende applicaties van de doelgroep. Het platform heeft een aparte server voor het tonen van statische publieke informatie. Voor de opslag van persoonlijke en medische gegevens wordt een losse, extra beveiligde, server gebruikt welke voldoet aan de wetgeving Algemene verordening gegevensbescherming (AVG).ConclusieDe gepresenteerde ontwerprichtlijnen geven een voorstel voor een online platform als antwoord op de hoofdvraag. Deze richtlijnen kunnen doorontwikkeld worden naar een prototype platform.
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Aim The aim of this study is to gain more insight into child and environmental factors that influence gross motor development (GMD) of healthy infants from birth until reaching the milestone of independent walking, based on longitudinal research. Background A systematic search was conducted using Scopus, PsycINFO, MEDLINE and CINAHL to identify studies from inception to February 2020. Studies that investigated the association between child or environmental factors and infant GMD using longitudinal measurements of infant GMD were eligible. Two independent reviewers extracted key information and assessed risk of bias of the selected studies, using the Quality in Prognostic Studies tool (QUIPS). Strength of evidence (strong, moderate, limited, conflicting and no evidence) for the factors identified was described according to a previously established classification. Results In 36 studies, six children and 11 environmental factors were identified. Five studies were categorized as having low risk of bias. Strong evidence was found for the association between birthweight and GMD in healthy full-term and preterm infants. Moderate evidence was found for associations between gestational age and GMD, and sleeping position and GMD. There was conflicting evidence for associations between twinning and GMD, and breastfeeding and GMD. No evidence was found for an association between maternal postpartum depression and GMD. Evidence for the association of other factors with GMD was classified as ‘limited’ because each of these factors was examined in only one longitudinal study. Conclusion Infant GMD appears associated with two child factors (birthweight and gestational age) and one environmental factor (sleeping position). For the other factors identified in this review, insufficient evidence for an association with GMD was found. For those factors that were examined in only one longitudinal study, and are therefore classified as having limited evidence, more research would be needed to reach a conclusion.
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Eén van de eerste uitdagingen voor een te vroeg geboren baby is het leren drinken uit fles of borst. Voor de meeste op tijd geboren kinderen levert dit geen problemen op, maar te vroeg geboren baby’s hebben meer moeite met het coördineren van het zuigen, slikken en ademen tijdens het drinken. Er zijn aanwijzingen dat deze zuig- en slikproblemen in de weken na geboorte geassocieerd zijn met ontwikkelingsproblemen op kinderleeftijd. Deze resultaten van dit onderzoek lijken te wijzen op een gevoelige periode in de ontwikkeling: als de problemen met het drinken nog aanwezig zijn in de 4 tot 6 weken na de uitgerekende datum betekent dat dat er een verhoogd risico is op ontwikkelingsproblemen op 2-jarige leeftijd.
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The intention of this chapter is to show how autoethnographic research might promote reflexivity among career professionals. We aim to answer the question: can writing one’s own life and career story assist career practitioners and researchers in identifying patterns, idiosyncrasies, vulnerabilities that will make them more aware of the elements that are fundamental to career construction and that have been mentioned in a variety of disparate places in the existing career literature? What interested us as career researchers and co-creators of the narrative approach Career Writing in considering the innovative intention of this book, was how writing our own career story could deepen our professional reflexivity and might also help others to do so. https://doi.org/10.1007/978-3-030-22799-9_30 LinkedIn: https://www.linkedin.com/in/reinekke-lengelle-phd-767a4322/
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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.
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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.
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Abstract Purpose To determine the predictive value of quality of life for mortality at the domain and item levels. Methods This longitudinal study was carried out in a sample of 479 Dutch people aged 75 years or older living independently, using a follow-up of 7 years. Participants completed a self-report questionnaire. Quality of life was assessed with the WHOQOL-BREF, including four domains: physical health, psychological, social relationships, and environment. The municipality of Roosendaal (a town in the Netherlands) indicated the dates of death of the individuals. Results Based on mean, all quality of life domains predicted mortality adjusted for gender, age, marital status, education, and income. The hazard ratios ranged from 0.811 (psychological) to 0.933 (social relationships). The areas under the curve (AUCs) of the four domains were 0.730 (physical health), 0.723 (psychological), 0.693 (social relationships), and 0.700 (environment). In all quality of life domains, at least one item predicted mortality (adjusted). Conclusion Our study showed that all four quality of life domains belonging to the WHOQOL-BREF predict mortality in a sample of Dutch community-dwelling older people using a follow-up period of 7 years. Two AUCs were above threshold (psychological, physical health). The findings offer health care and welfare professionals evidence for conducting interventions to reduce the risk of premature death.
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