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Adequate gross motor skills are an essential aspect of a child's healthy development. Where physical education (PE) is part of the primary school curriculum, a strong curriculum‐based emphasis on evaluation and support of motor skill development in PE is apparent. Monitoring motor development is then a task for the PE teacher. To fulfill this task, teachers need adequate tools. The 4‐Skills Scan is a quick and easily manageable gross motor skill instrument; however, its validity has never been assessed. Therefore, the purpose of this study was to assess the construct and concurrent validity of both 4‐Skills Scans (version 2007 and version 2015). A total of 212 primary school children (6‐12 years old) was requested to participate in both versions of the 4‐Skills Scan. For assessing construct validity, children covered an obstacle course with video recordings for observation by an expert panel. For concurrent validity, a comparison was made with the M‐ABC‐2, by calculating Pearson correlations. Multivariable linear regression analyses were performed to determine the contribution of each subscale to the construct of gross motor skills, according to the M‐ABC‐2 and the expert panel. Correlations between the 4‐Skills Scans and expert valuations were moderate, with coefficients of.47 (version 2007) and.46 (version 2015). Correlations between the 4‐Skills Scans and the M‐ABC‐2 (gross) were moderate (.56) for version 2007 and high (.64) for version 2015. It is concluded that both versions of the 4‐Skills Scans are satisfactory valid instruments for assessing gross motor skills during PE lessons. [ABSTRACT FROM AUTHOR]

Abstract Background Breastfeeding (BF) is protective against overweight and is associated with dietary behaviour. The aims of our study were to assess the relationship between exclusive BF duration and BMI, waist circumference (WC) and waist-hip ratio (WHR) at adulthood, and to study whether dietary behaviour could explain the relationship between BF duration and the proxies of fat mass. Methods In 2004-2005, 822 subjects from the Terneuzen Birth Cohort (n = 2,604), aged 18-28 years, filled in postal questionnaires including sociodemographic factors and aspects of dietary behaviour (dietary pattern, and consumption of fruit and vegetables, snacks, sweetened beverages and alcohol); 737 subjects also underwent anthropometric measurements of weight, height, and waist and hip circumference. The relationship between exclusive BF duration and dietary outcomes was investigated by logistic regression analysis. The relationships of BF duration with the anthropometric measures were investigated by linear regression analyses. All results were corrected for age, gender and possible confounders. Finally, regression analyses were performed to investigate if diet factors had a mediating effect on the relationship between BF duration and fat mass. Results A significant inverse dose-response relationship of BF duration was found for BMI (β-0.13, SE 0.06), WC (β-0.39, SE 0.18) and WHR (β-0.003, SE 0.001), after correction for age, gender and confounders. The odds ratio (OR) of exclusive BF duration in months for a breakfast frequency of at least 5 times a week was 1.16 (95%CI 1.06-1.27), and for snack consumption of less than twice a week was 1.15 (95%CI 1.06-1.25). Both ORs were corrected for age, gender and confounders. For other dietary outcomes, the results point in the same direction, i.e. a positive relationship with BF duration, but these were not statistically significant. A mediating effect of the diet factors on the association between BF and anthropometric outcomes was not shown. Conclusions Exclusive BF duration had a significant inverse dose-response relationship with BMI, WC and WHR at young adulthood. BF duration was positively related to a healthier diet at adulthood, but this did not explain the protective effect of BF against body fat. Our results underline the recommendation of the WHO to exclusively breastfeed for 6 months or longer.

Background: Early preterm (EP) born children are at risk of neurocognitive impairments persisting into adulthood. Less is known about moderately to late (MLP) preterm born children, especially after early childhood. The aim of this study was to assess neurocognitive functioning of MLP adolescents regarding intelligence, executive and attentional functioning, compared with EP and full-term (FT) adolescents., Methods: This study was part of the Longitudinal Preterm Outcome Project (LOLLIPOP), a large community-based observational cohort study. In total 294 children (81 EP, 130 MLP, and 83 FT) were tested at age 14 to 16 years, regarding intelligence, speed of processing, attention, and executive functions. We used the Dutch version of the Wechsler Intelligence Scale for Children-Third Edition-Dutch Version (WISC-III-NL), the Test of Everyday Attention for Children, and the Behavioural Assessment of the Dysexecutive Syndrome for Children. We assessed differences between preterm-born groups with the FT group as a reference., Results: Compared to the FT group, MLP adolescents scored significantly lower on two subtasks of the WISC-III-NL, i.e. Similarities and Symbol Search. EP adolescents performed significantly lower on all neuropsychological tests than their FT peers, except for the subtask Vocabulary. The MLP adolescents scored in between FT and EP adolescents on all tasks, except for three WISC-III-NL subtasks., Conclusions: Neurocognitive outcomes of MLP adolescents fell mostly in between outcomes of their EP and FT peers. MLPs generally performed on a low-average to average level, and appeared susceptible to a variety of moderate neurodevelopmental problems at adolescent age, which deserves attention in clinical practice., Competing Interests: Declaration of competing interest We declare no (potential) conflicts of interest for this study. The manuscript has not been submitted or published elsewhere, and will not so either, while under consideration by Early Human Development. The initial manuscript was drafted by Mrs. A.E. den Heijer, MSc. All authors have made substantial contributions to the research, critically revised the manuscript, approved the final version of the manuscript as submitted and accept full responsibility for its contents. Both the original LOLLIPOP study and the follow-up wave at adolescence were approved by the Medical Ethical Review Board of the University Medical Center Groningen (METc 2005/130 and METc 2017/01), the Netherlands. Both parents and children provided written informed consent to participate in the follow-up wave at adolescence., (Copyright © 2024. Published by Elsevier B.V.)

Objectives: To assess the relationship of diet with health-related quality of life (HRQoL) in vulnerable children and adolescents., Methods: Data included 6583 children and adolescents (aged 3-18 years old) from the Greek Food-Aid DIATROFI Program in the 2015 to 2016 and 2017 to 2018 school years. HRQoL was measured with the Pediatric Quality of Life Inventory questionnaire and diet with food frequency questionnaires. The healthy plant-based diet index (hPDI), animal score, and dietary patterns were investigated., Results: The hPDI and animal score were associated with good HRQoL (odds ratio [OR] [95% confidence interval], 10-unit increase: OR hPDI = 1.28 [1.05, 1.57], OR animal = 1.51 [1.14, 2.00]) and physical (OR animal = 1.62 [1.23, 2.13]), emotional (OR hPDI = 1.30 [1.07, 1.58], OR animal = 1.41 [1.08, 1.85]) and school function (OR hPDI = 1.32 [1.09, 1.59], OR animal = 1.46 [1.12, 1.89]). Dietary patterns of fruits, raw vegetables, and cheese were associated with good HRQoL (OR of 1-unit increase: 1.22 [1.13, 1.32]), and physical OR = 1.18 [1.09, 1.27]) and emotional function (OR = 1.09 [1.02, 1.18]). Starchy foods and sweetened beverages were associated with poor HRQoL (OR = 0.75 [0.63, 0.90]), and emotional (OR = 0.80 [0.68, 0.95]) and school function (OR = 0.72 [0.61, 0.85])., Conclusion: Healthy diets and dietary patterns were positively associated with the HRQoL of vulnerable children and adolescents, which may offer opportunities for prevention., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

The gut microbiome is involved in the bi-directional relationship of the gut - brain axis. As most studies of this relationship are small and do not account for use of psychotropic drugs (PTDs), we explored the relations of the gut microbiome with several internalizing disorders, while adjusting for PTDs and other relevant medications, in 7,656 Lifelines participants from the Northern Netherlands (5,522 controls and 491 participants with at least one internalizing disorder). Disorders included dysthymia, major depressive disorder (MDD), any depressive disorder (AnyDep: dysthymia or MDD), generalized anxiety disorder (GAD) and any anxiety disorder (AnyAnx: GAD, social phobia and panic disorder). Compared to controls, 17 species were associated with depressive disorders and 3 were associated with anxiety disorders. Around 90% of these associations remained significant (FDR <0.05) after adjustment for PTD use, suggesting that the disorders, not PTD use, drove these associations. Negative associations were observed for the butyrate-producing bacteria Ruminococcus bromii in participants with AnyDep and for Bifidobacterium bifidum in AnyAnx participants, along with many others. Tryptophan and glutamate synthesis modules and the 3,4-Dihydroxyphenylacetic acid synthesis module (related to dopamine metabolism) were negatively associated with MDD and/or dysthymia. After additional adjustment for functional gastrointestinal disorders and irritable bowel syndrome, these relations remained either statistically (FDR <0.05) or nominally ( P  < 0.05) significant. Overall, multiple bacterial species and functional modules were associated with internalizing disorders, including gut - brain relevant components, while associations to PTD use were moderate. These findings suggest that internalizing disorders rather than PTDs are associated with gut microbiome differences relative to controls.

Introduction: Smoking during pregnancy increases the risk of morbidity and mortality of the mother and child. The inability of the unborn child to protect itself, raises the social and academic responsibility to protect the child from the harmful effects of smoking. Interventions including rewards (incentives) for lifestyle changes are an upcoming trend and can encourage women to quit smoking. However, these incentives can, as we will argue, also have negative consequences, for example the restriction of personal autonomy and encouragement of smoking to become eligible for participation. To prevent these negative consequences, we developed an ethical framework that enables to assess and address unwanted consequences of incentive-based interventions whereby moral permissibility can be evaluated., Aims and Methods: The possible adverse consequences of incentives were identified through an extensive literature search. Subsequently, we developed ethical criteria to identify these consequences based on the biomedical ethical principles of Beauchamp and Childress., Results: Our framework consists of 12 criteria. These criteria concern (1) effectiveness, (2) support of a healthy lifestyle, (3) motivational for the target population, (4) stimulating unhealthy behavior, (5) negative attitudes, (6) personal autonomy, (7) intrinsic motivation, (8) privacy, (9) fairness, (10) allocation of incentives, (11) cost-effectiveness, and (12) health inequity. Based on these criteria, the moral permissibility of potential interventions can be evaluated., Conclusions: Incentives for smoking cessation are a response to the responsibility to protect the unborn child. But these interventions might have possible adverse effects. This ethical framework aims to identify and address ethical pitfalls in order to avoid these adverse effects., Implications: Although various interventions to promote smoking cessation during pregnancy exist, many women still smoke during pregnancy. Interventions using incentives for smoking cessation during pregnancy are a promising and upcoming trend but can have unwanted consequences. This ethical framework helps to identify and address ethical pitfalls in order to avoid these adverse effects.It can be a practical tool in the development and evaluation of these interventions and in evaluating the moral permissibility of interventions using incentives for smoking cessation during pregnancy., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.)

Purpose: To investigate whether the Geriatric 8 (G8) and the Timed Get Up and Go Test (TGUGT) and clinical and demographic patient characteristics were associated with acute toxicity of radiation therapy and noncompliance in elderly cancer patients being irradiated with curative intent., Methods and Materials: Patients were eligible if aged ≥65 years and diagnosed with breast, non-small cell lung, prostate, head and neck, rectal, or esophageal cancer, and were referred for curative radiation therapy. We recorded acute toxicity and noncompliance and identified potential predictors, including the G8 and TGUGT., Results: We investigated 402 patients with a median age of 72 years (range, 65-96 years). According to the G8, 44.4% of the patients were frail. Toxicity grade ≥3 was observed in 22% of patients who were frail according to the G8 and 9.1% of patients who were not frail. The difference was 13% (confidence interval 5.2%-20%; P=.0006). According to the TGUGT 18.8% of the patients were frail; 21% of the frail according to the TGUGT developed toxicity grade ≥3, compared with 13% who were not frail. The difference was 7.3% (confidence interval -2.7% to 17%; P=.11). Overall compliance was 95%. Toxicity was most strongly associated with type of primary tumor, chemotherapy, age, and World Health Organization performance status. Compliance was associated with type of primary tumor and age., Conclusions: The usefulness of the TGUGT and G8 score in daily practice seems to be limited. Type of primary tumor, chemoradiotherapy, age, and World Health Organization performance status were more strongly associated with acute toxicity. Only chemoradiotherapy and age were associated with noncompliance. Overall the compliance was very high. To allow better-informed treatment decisions, a more accurate prediction of toxicity is desirable., (Copyright © 2017. Published by Elsevier Inc.)

This paper presents the validation and further miniaturisation of the well-known Dutch mini-Luke method for high water and acid content matrices for 175 pesticides amenable to liquid- and gas chromatography-mass spectrometry. For optimisation of the method, recovery tests with different sample/extraction solvent ratios, varying amounts of dichloromethane and salts were performed with fifty representative pesticides. Solvent consumption could be reduced considerably, especially for the dichloromethane (by a factor of 3). Recovery studies performed with lettuce and orange matrix spiked at 0.005, 0.01 and 0.02 mg/kg yielded average recoveries in the range 70-120% with relative standard deviation values below 20% for almost all the pesticides tested. The linearity over three orders of magnitude was demonstrated (r(2) > 0.99). The matrix effect could be considered as not significant. The limit of quantification was 0.005 mg/kg for 96% of the compounds. The optimised New Dutch mini-Luke ("NL"-) method was applied successfully in routine analysis and the EUPT FV-16 sample., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

In this study, a new gas chromatography-mass spectrometry (GC-MS) method, using the very selective negative chemical ionization (NCI) mode, was developed and applied in combination with a modified acetonitrile-based extraction method (QuEChERS) for the analysis of a large number of pesticide residues (51 pesticides, including isomers and degradation products) in green coffee beans. A previously developed integrated sample homogenization and extraction method for both pesticides and mycotoxins analysis was used. An homogeneous slurry of green milled coffee beans and water (ratio 1:4, w/w) was prepared and extracted with acetonitrile/acetic acid (1%), followed by magnesium sulfate addition for phase separation. Aliquots from this extract could be used directly for LC-MS/MS analysis of mycotoxins and LC-amenable pesticides. For GC-MS analysis, a further clean-up was necessary. C18- and PSA-bonded silica were tested as dispersive solid-phase extraction (d-SPE) sorbents, separate and as a mixture, and the best results were obtained using C18-bonded silica. For the optimal sensitivity and selectivity, GC-MS detection in the NCI-selected ion monitoring (SIM) mode had to be used to allow the fast analysis of the difficult coffee bean matrix. The validation was performed by analyzing recovery samples at three different spike concentrations, 10, 20 and 50 μg kg(-1), with 6 replicates (n=6) at each concentration. Linearity (r(2)) of calibration curves, estimated instrument and method limits of detection and limits of quantification (LOD(i), LOD(m), LOQ(i) and LOQ(m), respectively), accuracy (as recovery %), precision (as RSD%) and matrix effects (%) were determined for each individual pesticide. From the 51 analytes (42 parent pesticides, 4 isomers and 5 degradation products) determined by GC-MS (NCI-SIM), approximately 76% showed average recoveries between 70-120% and 75% and RSD ≤ 20% at the lowest spike concentration of 10 μg kg(-1), the target method LOQ. For the spike concentrations of 20 and 50 μg kg(-1), the recoveries and RSDs were even better. The validated LOQ(m) was 10, 20 and 50 μg kg(-1) for respectively 33, 3 and 6 of the analytes studied. For five compounds, the European Union method performance requirements for the validation of a quantitative method (average recoveries between 70-120% and repeatability RSD ≤ 20%) were not achieved and 4 problematic pesticides (captan, captafol, folpet and dicofol) could not be detected as their parent compound, but only via their degradation products. Although the matrix effect (matrix-enhanced detector response) was high for all pesticides studied, the matrix interference was minimal, due to the high selectivity obtained with the GC-NCI-MS detection. Matrix-matched calibration for applying the method in routine analysis is recommended for reliable quantitative results., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: Quality of life (QoL) has become an important outcome measure in health care, including in child psychiatry., Aim: To formulate assessment criteria with regard to instruments that are designed to measure QoL in children., Method: Literature search, using five key electronic databases. results When selecting an instrument, one has to consider the following aspects: its validity and reliability, the relative dimensions of QoL, its suitability for use with both the child and its parents and its cross-cultural applicability. A number of instruments were found to meet these criteria., Conclusion: The Child Quality of Life Questionnaire, the Revidierter Kinder Lebensqualit"atsfragebogen, the tno-azl Children's Quality of Life questionnaire, the Pediatric Quality of Life Inventory, the Child Health Questionnaire and in particular the kidscreen show to be suitable instruments for assessing QoL in children.

Background: Pregnant women are encouraged to book for antenatal care. However, little is known about the contents of antenatal care, in particular regarding various test procedures. The present descriptive study was conducted to assess the variation in standard test procedures in antenatal care in The Netherlands., Methods: A nationwide structured survey by mailed questionnaire was carried out among specialist obstetricians and midwives in The Netherlands. Representatives of each obstetric practice registered with the Dutch Society of Obstetrics and Gynecology (n=132) and a sample of midwives registered with the Dutch Society of Midwives (n=394) were invited to report the standard policy of tests routinely used for antenatal care in their own setting. Furthermore, they were asked to report their views on the potential impact of the antenatal care program on pregnancy outcome., Results: Complete information was available from 105 specialist obstetricians (80%) and 281 midwives (71%). The assessment of maternal blood pressure and weight are reportedly the commonest procedures routinely conducted during the antenatal period. However, within each profession reported definitions and implications of abnormal findings vary markedly, especially in the fields of identification and management of hypertensive disorders in pregnancy. Serial examination of the cervix is not standard policy among both groups. With respect to laboratory tests, considerable intra- and interprofessional variations are reported, in particular those for maternal serum glucose, rubella antibody titer and urinary dipstick for glucose and protein. As to standard ultrasound policies, wide intra- and interprofessional variations are noted. Seventy-two specialist obstetricians (68%) and 92 midwives (33%) routinely estimate the duration of gestation by ultrasound in pregnant women (p<0.001). A fetal anomaly scan at about 18-20 weeks' gestation is routinely offered to pregnant women by 31 specialist obstetricians (30%) and 44 midwives (16%) (p<0.01); 29 obstetricians (28%) and 11 midwives (4%) reportedly use ultrasound in all pregnant women for the detection of fetal growth restriction (p<0.001). Overall, midwives have a more optimistic view about the impact of antenatal care on pregnancy outcome than obstetricians., Conclusions: Although the standard package of antenatal care provided by both specialist obstetricians and midwives in The Netherlands seems to be relatively uniform, wide intra- and interprofessional variations exist with respect to (1) the application of tests in terms of recommendations to test some or all pregnant women, (2) defining normal from abnormal and (3) potential implications of abnormal findings.

High frequency intravascular ultrasound may show a high intensity backscatter from blood which hampers the discrimination between lumen and arterial wall. In this study, the acoustic behaviour of blood at 30 MHz in relation to rouleau size was analyzed. In a Couette viscometer, high frequency (20-40 MHz) backscatter data from normal and modified blood samples from eight volunteers were obtained at shear rates from 0 to 1000 s-1. The acoustic behaviour of blood was quantified by the integrated backscatter power and the spectral slope of the backscatter coefficient. Backscatter from blood depended on rouleau size. At a shear rate of zero, both whole blood and rouleau-enhanced blood showed a 11-dB-higher integrated backscatter power than rouleau-suppressed blood, which itself was 10 dB higher than that of hemolysed blood, the latter showing a 6-dB-higher backscatter than saline. Platelets did not contribute to the backscatter power. Plasma and saline produced no detectable integrated backscatter power other than noise. The spectral slope of whole and rouleau-enhanced blood was small (1 and 0.5, respectively), whereas rouleau-suppressed blood and hemolysed blood (both with a slope of 3.3) behaved almost like a Rayleigh scattering medium (slope = 4). The backscatter from rouleau-suppressed blood showed no shear rate dependence. At low shear rates ( < 0.8 s-1 for integrated backscatter power and < 0.2 s-1 for the spectral slope), whole blood and rouleau-enhanced blood tended to the results from the static situation (no shear). At high shear rates ( > 80 s-1 for integrated backscatter power and >11 s-1 for spectral slope), these samples tended to the results of rouleau-suppressed blood. Ultrasound backscatter at 30 MHz from human blood is only caused by red blood cells. With increasing aggregate (rouleau) size, the integrated backscatter power increased by 11 dB, and the spectral slope decreased from 3.3 to 1.

Ultrasound images from human arteries obtained in vivo with an intravascular 30 MHz ultrasound imaging device show that blood echogenicity changes during the cardiac cycle. Quantitative measurements of blood echogenicity during the cardiac cycle suggest that these variations may be related to changes in the state of erythrocyte aggregation, which are induced by varying shear rate.

The anisotropic nature of intra-arterial echographic images is reported, and the source of this anisotropy is investigated using postmortem human iliac arteries. A 27 MHz transducer, mounted on an ultrasonic microscope, is used to quantify the angular dependence of the backscatter power versus the angle of incidence, and these results are correlated with histological findings. Besides the observed differences in the acoustic response of morphologically different tissues, significant variations in backscatter power are found in both media and internal elastic lamina due to variations in the angle of incidence. This angle dependence is caused by the dominant orientation of fibers in tissue layers and by the shape and size various scattering particles. The results indicate that long microscopic structures with one main orientation are responsible for the backscattered signal and that the angular-dependent response is related to the histologically determined orientation of these fibers. These results may have an impact on the assessment of intra-arterial echographic images.