This version is distributed under a non-commencial no derivatives Creative Commons (CC-BY-NC-ND) user license, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and not used for commercial purposes. Further, the restriction applies that if you remix, transform, or build upon the material, you may not distribute the modified material. (25(OH)D) and cognitive performance was examined. Secondly, we assessed 6 whether there was evidence for an interplay between 25(OH)D and glucose 7 homeostasis in the association with cognitive performance. 8 9 Design, Setting and Participants: Associations were studied using cross-10 sectional data of 776 (3 domains) up to 2722 (1 domain) Dutch community-11 dwelling older adults, aged ≥65 years. Results: The overall median MMSE score was 29 synthesis, choline acetyltransferase activity, and amyloid clearance (reviewed 52 in 2-4 ). Finally, besides these direct pathways between vitamin D and cognitive 53 performance, one might also think of indirect pathways. For instance, vitamin 54 D deficiency has been associated with glucose intolerance 6 . Glucose 55 intolerance on its turn has been related to both vascular damage and 56 cognitive decline 7 . Accordingly, it may be that the potential favourable effect 57 of vitamin D on cognitive performance can be partially explained by its 58 beneficial effect on glucose tolerance. It may also be that glucose tolerance 59 biologically interacts with vitamin D. Therefore, it may be that the potential 60 association between vitamin D and cognitive function appears to be stronger 61 5 in persons with glucose intolerance than in their glucose tolerant counterparts. 62These possible pathways, however, have only been examined in a few 63 studies [8][9][10][11][12] . 64 65 So far, results from observational studies 1,[8][9][10][11][13][14][15][16][17][18] Biochemical analyses 142Blood samples were drawn in the morning when the participants were fasted 143 or had consumed a restricted breakfast. Samples were stored at -80 ˚C until 144 determination. Serum 25(OH)D was measured by isotope dilution -online 145 9 solid phase extraction liquid chromatography -tandem mass spectrometry 146 (ID-XLC-MS/MS) 28 . Plasma glucose concentrations were analysed using a 147 hexokinase method (Gluco-quant, Roche Diagnostics). Insulin levels were 148 determined using an immunometric assay (ADVIA Centaur immunoassay 149 system, Siemens Medical Solutions Diagnostics). Creatinine concentration 150 was measured using the enzymatic colorimetric Roche CREA plus assay. 151 152Covariates 153 Height was measured at baseline with a stadiometer to the nearest 0.1 cm. 154Weight was measured to the nearest 0.5 kg with a calibrated analogues scale. association with cognitive performance was tested. In case of significant 213 findings, data was also presented stratified. 214 12 A P-value of <0.05 was used to determine statistical significance. Analyses 215 were performed using the statistical package SAS, version 9.1 (S...
Introduction The goal of newborn bloodspot screening (NBS) is the early detection of treatable disorders in newborns to offer early intervention. Worldwide, the number of conditions screened for is expanding, which might affect public acceptance. In the Netherlands, participation is high (>99%), but little is known about how parents perceive NBS. This study assessed parents’ views on accepting, declining and expanding NBS. Methods A total of 804 of 6051 (13%) invited parents who participated in NBS in the Netherlands during the last two weeks of December 2019, and 48 of 1162 (4%) invited parents who declined participation in NBS in 2019 and 2020, completed a questionnaire. Results The most important reason for parents to participate in NBS was to prevent health complaints, whereas the most important reason to decline NBS was parents’ viewpoint on life and the belief that the heel prick would be painful for the child. Compared to NBS participants, respondents who declined NBS were more actively religious, considered alternative medicine or lifestyle more important, were less inclined to vaccinate their child for infectious diseases, and reported more doubt about NBS participation (all differences p < .001). Informed choice was lower among respondents who declined NBS (44%) compared to participants in NBS (83%, p < .001), mostly due to insufficient knowledge. Of the NBS participants, 95% were positive about NBS expansion. Most NBS participants agreed to include conditions that could unintentionally reveal a diagnosis in the mother instead of the child (86%) or a condition that may not cause symptoms until later in the child’s life (84%). Conclusion Most participants made an informed decision to participate in NBS and are positive about screening for more conditions. Insights into parents’ views on (non-)participation and expansion of NBS can help to ensure that NBS suits the population needs while safeguarding ethical principles for screening.
Background Many parents frequently struggle with undesirable or problematic behavior (ie, temper tantrums and whining) displayed by their child. To support parents in promoting positive parenting skills (ie, recognizing challenging situations and reacting appropriately), the interactive video e-learning tool ParentCoach was developed. The tool aims to teach parents generic behavioral responses by means of situational learning, tailoring, and problem solving. The first demonstration focused on sleeping problems. Objective The aim of this paper is to illustrate the user-centered development of ParentCoach. Methods We conducted usability, understandability, and acceptance tests among the target group (29 parents, 7 youth health care professionals, and 4 individuals with former lower health literacy) in different phases of the development process via focus groups, interviews, and surveys. This allowed for relevant insights on specifications and user requirements to guide the development and revision of the tool in each iteration. Results Iterative testing and development allowed for the final demonstration of ParentCoach to be experienced as a relevant and accessible parenting intervention that can be used as a stand-alone program or in combination with another program. Conclusions This paper elaborates on the iterative development process and its benefits for the final demonstration of ParentCoach.
BACKGROUND Many parents frequently struggle with undesirable or problematic behavior (ie, temper tantrums and whining) displayed by their child. To support parents in promoting positive parenting skills (ie, recognizing challenging situations and reacting appropriately), the interactive video e-learning tool <i>ParentCoach</i> was developed. The tool aims to teach parents generic behavioral responses by means of situational learning, tailoring, and problem solving. The first demonstration focused on sleeping problems. OBJECTIVE The aim of this paper is to illustrate the user-centered development of ParentCoach. METHODS We conducted usability, understandability, and acceptance tests among the target group (29 parents, 7 youth health care professionals, and 4 individuals with former lower health literacy) in different phases of the development process via focus groups, interviews, and surveys. This allowed for relevant insights on specifications and user requirements to guide the development and revision of the tool in each iteration. RESULTS Iterative testing and development allowed for the final demonstration of ParentCoach to be experienced as a relevant and accessible parenting intervention that can be used as a stand-alone program or in combination with another program. CONCLUSIONS This paper elaborates on the iterative development process and its benefits for the final demonstration of ParentCoach.
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