A Dutch paediatric palliative care guideline: a systematic review and recommendations on advance care planning and shared decision-making.

Background: In paediatric palliative care, children with life-threatening and life-limiting conditions, their families, and their health care professionals often face difficult decisions about treatment, goals of care, and delivery of care. Advance care planning and shared decision-making are strategies that can improve quality of care by discussing goals and preferences on future care. In this paper, we provide recommendations that aim to optimise advance care planning and shared decision-making in paediatric palliative care in the Netherlands.

A Dutch paediatric palliative care guideline: a systematic review and evidence-based recommendations for symptom treatment.

Background: Children with life-threatening and life-limiting conditions can experience high levels of suffering due to multiple distressing symptoms that result in poor quality of life and increase risk of long-term distress in their family members. High quality symptom treatment is needed for all these children and their families, even more so at the end-of-life. In this paper, we provide evidence-based recommendations for symptom treatment in paediatric palliative patients to optimize care.

Palliative care for children: methodology for the development of a national clinical practice guideline.

Background: Provision of paediatric palliative care for children with life-threatening or life-limiting conditions and their families is often complex. Guidelines can support professionals to deliver high quality care. Stakeholders expressed the need to update the first Dutch paediatric palliative care guideline with new scientific literature and new topics.

Participation in Social Roles of Adolescents With Cerebral Palsy: Exploring Accomplishment and Satisfaction.

Objective: To explore participation in social roles of adolescents (aged 12-18y) with cerebral palsy (CP), in terms of satisfaction compared with accomplishment.

Design: Cohort study as part of a prospective longitudinal research program.

Setting: Clinic.

LEARN2MOVE 0-2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: family outcome and infant's functional outcome.

To compare family and functional outcome in infants at very high risk of cerebral palsy, after receiving the family centred programme "Coping with and Caring for infants with special needs (COPCA)" or typical infant physiotherapy. Forty-three infants at very high risk were included before 9 months corrected age and randomly assigned to one year COPCA ( = 23) or typical infant physiotherapy ( = 20). Family and infant outcome were assessed before and during the intervention.

LEARN2MOVE 0-2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: neuromotor, cognitive, and behavioral outcome.

Evidence for efficacy of early intervention in infants at high risk of cerebral palsy (CP) is limited. We compared outcome of infants at very high risk of CP after receiving the family centered program COPing with and CAring for infants with special needs (COPCA) or typical infant physiotherapy. Forty-three infants were randomly assigned before the corrected age of 9 months to 1 year of COPCA ( = 23) or typical infant physiotherapy ( = 20).

Managing oneself or managing together? Parents' perspectives on chronic condition self-management in Dutch pediatric rehabilitation services.

With the growing attention in pediatric rehabilitation services for supporting self-management, the need increases for more shared understanding of the concept. The aim of this study was to explore parent activation, associated factors of- and underlying perceptions on parental self-management of parents of children with chronic conditions. Using a mixed-methods strategy, first variations in self-management behaviors, motivation and perceived autonomy support were assessed with a cross-sectional survey among parents of children with chronic conditions ( = 239).

Translation and cross-cultural adaptation of the PEDI-CAT: Dutch version.

Purpose: The PEDI-CAT measures daily functioning of children and youth, aged 1 to 21 years, with a variety of physical, cognitive and/or behavioral disabilities. In order to use an instrument in another culture or language, translation and cross-cultural validation are important, particularly for end-users. This study describes the process of translation and cross-cultural adaptation of the Dutch version of the PEDI-CAT.

How do adolescents with cerebral palsy participate? Learning from their personal experiences.

Background: Participation in society can be difficult for adolescents with cerebral palsy (CP). Information is often based on quantitative studies, and little is known about their personal participation experiences.

Objective: The aim of this study was to examine the participation experiences of adolescents (aged 12-17 years) with CP.

Efficacy of three therapy approaches in preschool children with cerebral palsy: a randomized controlled trial.

Aim: To examine the efficacy of child-focused, context-focused, and regular care approaches, delivered in a rehabilitation setting by physical or occupational therapists to preschool children with cerebral palsy (CP), in optimizing the child's self-care and mobility capabilities.

Method: A multicentre randomized controlled trial clustered at therapist level was conducted in 13 rehabilitation centres. It included 68 children with CP (38 males, 30 females; mean age 3y, SD 6mo, range 1y 11mo-4y), classified as Gross Motor Function Classification System levels I to IV, who were already receiving therapy.

Parents' experiences with physical and occupational therapy for their young child with cerebral palsy: a mixed studies review.

Understanding the experiences of parents with their child's intervention might help meet the needs of parents and, subsequently get them engaged in their child's intervention. As parents' early beliefs regarding their child's intervention has consequences for treatment participation, it is important to understand these parental perspectives. The aim of this mixed studies review was to give an overview of the experiences and related factors of parents of young children (0-5 years of age) with cerebral palsy in relation to the physical and/or occupational therapy of their child in a rehabilitation setting.

Medical and psychosocial problems in middle-aged spina bifida patients: survey among members of the Dutch patients' association.

Purpose: To identify physical, emotional and psychosocial issues in the older person with spina bifida (SB).

Method: Members of the Dutch patients' association aged >25 years (n = 184) were asked to complete a questionnaire. This survey contained questions on physical and psychosocial complaints, as well as problems regarding social participation.

LEARN 2 MOVE 2-3: a randomized controlled trial on the efficacy of child-focused intervention and context-focused intervention in preschool children with cerebral palsy.

Background: Little is known about the efficacy and the working mechanisms of physical and occupational therapy interventions for children with cerebral palsy (CP). In recent years a shift from a child-focused intervention approach to a more context-focused intervention approach can be recognized. Until now the evidence on the efficacy and the working mechanisms of these interventions for children with CP is inconclusive.

LEARN 2 MOVE 7-12 years: a randomized controlled trial on the effects of a physical activity stimulation program in children with cerebral palsy.

Background: Regular participation in physical activities is important for all children to stay fit and healthy. Children with cerebral palsy have reduced levels of physical activity, compared to typically developing children. The aim of the LEARN 2 MOVE 7-12 study is to improve physical activity by means of a physical activity stimulation program, consisting of a lifestyle intervention and a fitness training program.

LEARN 2 MOVE 0-2 years: effects of a new intervention program in infants at very high risk for cerebral palsy; a randomized controlled trial.

Background: It is widely accepted that infants at risk for cerebral palsy need paediatric physiotherapy. However, there is little evidence for the efficacy of physiotherapeutic intervention. Recently, a new intervention program, COPCA (Coping with and Caring for infants with special needs - a family centered program), was developed.

Improving adaptation to weaning: effect of intermittent suckling regimens on piglet feed intake, growth, and gut characteristics.

Daily separation of sows and piglets during lactation, intermittent suckling (IS), improves feed intake and postweaning adaptation in piglets. The aim of the current study was to determine how, in piglets that have been subjected to IS, age at weaning and the duration of the preceding IS period contribute to postweaning adaptation through effects on feed intake, growth, and gut characteristics. All piglets had ad libitum access to creep feed from d 7.

Population dynamics of swine influenza virus in farrow-to-finish and specialised finishing herds in the Netherlands.

Influenza virus infections with subtypes H1N1, H3N2 and H1N2 are very common in domestic pigs in Europe. Data on possible differences of population dynamics in finishing pigs in farrow-to-finish herds and in specialised finishing herds are, however, scarce. The presence of sows and weaned piglets on the same premises may, however, affect the exposure of finishing pigs to influenza viruses.

Citrulline and intestinal fatty acid-binding protein: longitudinal markers of postweaning small intestinal function in pigs?

The objective of the current study was to investigate whether plasma citrulline or intestinal fatty acid-binding protein (I-FABP) concentrations might be used as longitudinal markers for small intestinal function in piglets after weaning. Plasma citrulline and I-FABP concentrations were measured longitudinally in weaned and unweaned piglets, and related to intestinal absorption values (i.e.

Transmission of infectious bronchitis virus within vaccinated and unvaccinated groups of chickens.

The aim of this study was to determine whether vaccination against infectious bronchitis virus (IBV) reduces virus transmission, i.e. to test whether IBV transmission among vaccinated chickens is significantly reduced compared to that among unvaccinated chickens.

Health issues in young adults with cerebral palsy: towards a life-span perspective.

Objective: To obtain better insight into the health issues of young adults with cerebral palsy.

Design: Cross-sectional.

Subjects: Two data sources were used: 54 adults with cerebral palsy (age range 25-36 years) and 48 physicians (members of the Netherlands Society of Physical and Rehabilitation Medicine).

Intermittent suckling during an extended lactation period: effects on piglet behavior.

The objectives of the current study were to determine how intermittent suckling (IS) affects nursing behavior, litter activity, and general behavioral patterns during lactation, and whether IS during an extended lactation period results in behavioral patterns associated with piglet distress. Intermittent suckling was applied either with 6-h separation intervals (IS6) or with 12-h separation intervals (IS12) and was compared with the conventional treatment (CT). In the CT (n = 17 litters), sows were continuously present until weaning (d 21, d 0 = farrowing).

Effect of herd characteristics, management practices, and season on different categories of the herd somatic cell count.

In this study, the contribution of management practices, herd characteristics, and seasonal variables to the herd somatic cell count (SCC) was quantified in herds with low (<150,000 cells/mL), medium (150,000-200,000 cells/mL), and high (>200,000 cells/mL) herd SCC (HSCC). Selection of the variables was performed using a linear mixed effect model; HSCC was calculated as the arithmetic mean of the individual cow's SCC. The data concerning management practices were derived from 3 questionnaires on mastitis prevention and management practices on 246 Dutch dairy farms.

Addition of chromic oxide to creep feed as a fecal marker for selection of creep feed-eating suckling pigs.

Objective: To determine whether the addition of chromic oxide (Cr(2)O(3)) to creep feed could be used as a visual marker in feces for selection of creep feed-eating suckling pigs.

Animals: 20 suckling pigs.

Procedures: Via syringe, 5 pigs (2 to 3 days old on day 0; 1 pig/treatment) from each of 4 litters received oral administrations of 10, 20, 30, or 40 g of creep feed containing 10 g of Cr(2)O(3)*kg(1) on each of 2 consecutive days (days 20 and 21) or 30 g of creep feed containing 10 g of Cr(2)O(3)*kg(1) on day 20 and 30 g of Cr(2)O(3)-free creep feed on day 21.

Elimination of strains of Streptococcus suis serotype 2 from the tonsils of carrier sows by combined medication and vaccination.

The effect of vaccination with a killed whole-cell vaccine of extracellular factor-positive Streptococcus suis serotype 2 (S suis 2 EF(+)) combined with medication with amoxicillin on the presence of virulent S suis 2 EF(+) strains on the tonsils of sows and their offspring was evaluated. In two herds, 14 pregnant sows that carried these virulent strains, as detected by PCR in three consecutive tonsillar brush samples, were selected and randomly assigned to be treated or left untreated as controls. The treated sows were vaccinated at six and three weeks before the expected farrowing date and medicated from one week before expected farrowing until the end of the experiment.

Effects of intermittent suckling and creep feed intake on pig performance from birth to slaughter.

An experiment was conducted to determine if the improved creep feed intake observed during intermittent suckling (IS) is important for postweaning performance. Therefore, creep feed intake of litters was assessed, and within litters, eaters and noneaters were distinguished using chromic oxide as an indigestible marker. Batches of sows were suckled intermittently (IS, 7 batches; n = 31) or continuously (control, 7 batches; n = 31).