Food, nutrition & behaviour : research for healthy eating, healthy living

This brochure illustrates this range of research activities in the domain of food and nutrition, lifestyle and health. It does so by providing examples of collaboration of Wageningen UR with partners in the public and private sector

Organizational Probes:Exploring Playful Interactions in Work Environment

Playfulness, with non-intrusive elements, can be considered a useful resource for enhancing social awareness and community building within work organizations. Taking inspirations from the cultural probes approach, we developed organizational probes as a set of investigation tools that could provide useful information about employees’ everyday playful experiences within their work organizations. In an academic work environment, we applied our organizational probes over a period of three weeks. Based on the collected data we developed two design concepts for playful technologies in work environments

Mergers of close primordial binaries

We study the production of main sequence mergers of tidally-synchronized primordial short-period binaries. The principal ingredients of our calculation are the angular momentum loss rates inferred from the spindown of open cluster stars and the distribution of binary properties in young open clusters. We compare our results with the expected number of systems that experience mass transfer in post-main sequence phases of evolution and compute the uncertainties in the theoretical predictions. We estimate that main-sequence mergers can account for the observed number of single blue stragglers in M67. Applied to the blue straggler population, this implies that such mergers are responsible for about one quarter of the population of halo blue metal poor stars, and at least one third of the blue stragglers in open clusters for systems older than 1 Gyr. The observed trends as a function of age are consistent with a saturated angular momentum loss rate for rapidly rotating tidally synchronized systems. The predicted number of blue stragglers from main sequence mergers alone is comparable to the number observed in globular clusters, indicating that the net effect of dynamical interactions in dense stellar environments is to reduce rather than increase the blue straggler population. A population of subturnoff mergers of order 3-4% of the upper main sequence population is also predicted for stars older than 4 Gyr, which is roughly comparable to the small population of highly Li-depleted halo dwarfs. Other observational tests are discussed.Comment: number of pages depends on font, margins, columns etc (58 with given format), 14 figures, submitted to the Astrophysical Journa

Quality of life in Dutch patients with primary biliary cholangitis:Discrepancies between patients’ perspectives and objective disease parameters

Aim: This study aims to assess the health-related quality of life (HRQoL) in a Dutch population of patients with primary biliary cholangitis (PBC) in relation to the prognosis and need for second line-therapy, based on both objective disease parameters and patients’ perspectives. Methods: In this cross-sectional multicenter study, HRQoL was assessed by using the Dutch PBC-40 according to objective clinical parameters and patients’ perspectives on treatment and prognosis. Results: In total, 178/269 (66%) patients responded; mean age 61.2 (SD 9.9) years and 165 (92.7%) women. The PBC-40 domain scores did not differ according to the GLOBE score response (p &gt; 0.05 for all) or according to the POISE criteria (p &gt; 0.05), except for the domain itch (p = 0.031). Patients who considered their survival to be impaired scored higher on all domains as compared to those expecting a normal prognosis (p &lt; 0.05). Similarly, PBC-40 domain scores were higher among patients who considered that they were in need of additional therapy compared to those who did not (p &lt; 0.05 for all, except for domain itch [p = 0.056]). However, 45/62 (72.6%) patients with a self-expected impaired prognosis had a GLOBE score indicative of a normal prognosis. Twenty-five of the 40 (62.5%) patients who believed they needed additional therapy were below POISE criteria. Conclusion: The HRQoL of patients with PBC was impaired in terms of nonfavorable disease status according to the expectations of patients, but not according to objective disease parameters. Substantial discrepancies between patients’ perspectives and objective parameters were observed, which highlights the need for better patient guidance among patient with PBC.</p

Loneliness Literacy Scale: Development and Evaluation of an Early Indicator for Loneliness Prevention

To develop and evaluate the Loneliness Literacy Scale for the assessment of short-term outcomes of a loneliness prevention programme among Dutch elderly persons. Scale development was based on evidence from literature and experiences from local stakeholders and representatives of the target group. The scale was pre-tested among 303 elderly persons aged 65 years and over. Principal component analysis and internal consistency analysis were used to affirm the scale structure, reduce the number of items and assess the reliability of the constructs. Linear regression analysis was conducted to evaluate the association between the literacy constructs and loneliness. The four constructs “motivation”, “self-efficacy”, “perceived social support” and “subjective norm” derived from principal component analysis captured 56 % of the original variance. Cronbach’s coefficient α was above 0.7 for each construct. The constructs “self-efficacy” and “perceived social support” were positively and “subjective norm” was negatively associated with loneliness. To our knowledge this is the first study developing a short-term indicator for loneliness prevention. The indicator contributes to the need of evaluating public health interventions more close to the intervention activities. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11205-013-0322-y) contains supplementary material, which is available to authorized users

Implementing quality indicators in intensive care units: exploring barriers to and facilitators of behaviour change

<p/> <p>Background</p> <p>Quality indicators are increasingly used in healthcare but there are various barriers hindering their routine use. To promote the use of quality indicators, an exploration of the barriers to and facilitating factors for their implementation among healthcare professionals and managers of intensive care units (ICUs) is advocated.</p> <p>Methods</p> <p>All intensivists, ICU nurses, and managers (n = 142) working at 54 Dutch ICUs who participated in training sessions to support future implementation of quality indicators completed a questionnaire on perceived barriers and facilitators. Three types of barriers related to knowledge, attitude, and behaviour were assessed using a five-point Likert scale (1 = strongly disagree to 5 = strongly agree).</p> <p>Results</p> <p>Behaviour-related barriers such as time constraints were most prominent (Mean Score, MS = 3.21), followed by barriers related to knowledge and attitude (MS = 3.62; MS = 4.12, respectively). Type of profession, age, and type of hospital were related to knowledge and behaviour. The facilitating factor perceived as most important by intensivists was administrative support (MS = 4.3; p = 0.02); for nurses, it was education (MS = 4.0; p = 0.01), and for managers, it was receiving feedback (MS = 4.5; p = 0.001).</p> <p>Conclusions</p> <p>Our results demonstrate that healthcare professionals and managers are familiar with using quality indicators to improve care, and that they have positive attitudes towards the implementation of quality indicators. Despite these facts, it is necessary to lower the barriers related to behavioural factors. In addition, as the barriers and facilitating factors differ among professions, age groups, and settings, tailored strategies are needed to implement quality indicators in daily practice.</p

Validity of absolute intake and nutrient density of protein, potassium, and sodium assessed by various dietary assessment methods:An exploratory study

It is suggested that nutrient densities are less affected by measurement errors than absolute intake estimates of dietary exposure. We compared the validity of absolute intakes and densities of protein (kJ from protein/total energy (kJ)), potassium, and sodium (potassium or sodium (in mg)/total energy (kJ)) assessed by different dietary assessment methods. For 69 Dutch subjects, two duplicate portions (DPs), five to fifteen 24-h dietary recalls (24 hRs, telephone-based and web-based) and two food frequency questionnaires (FFQs) were collected and compared to duplicate urinary biomarkers and one or two doubly labelled water measurements. Multivariate measurement error models were used to estimate validity coefficients (VCs) and attenuation factors (AFs). This research showed that group bias diminished for protein and sodium densities assessed by all methods as compared to the respective absolute intakes, but not for those of potassium. However, the VCs and AFs for the nutrient densities did not improve compared to absolute intakes for all four methods; except for the AF of sodium density (0.71) or the FFQ which was better than that of the absolute sodium intake (0.51). Thus, using nutrient densities rather than absolute intakes does not necessarily improve the performance of the DP, FFQ, or 24 hR.</p

Convection, Thermal Bifurcation, and the Colors of A stars

Broad-band ultraviolet photometry from the TD-1 satellite and low dispersion spectra from the short wavelength camera of IUE have been used to investigate a long-standing proposal of Bohm-Vitense that the normal main sequence A- and early-F stars may divide into two different temperature sequences: (1) a high temperature branch (and plateau) comprised of slowly rotating convective stars, and (2) a low temperature branch populated by rapidly rotating radiative stars. We find no evidence from either dataset to support such a claim, or to confirm the existence of an "A-star gap" in the B-V color range 0.22 <= B-V <= 0.28 due to the sudden onset of convection. We do observe, nonetheless, a large scatter in the 1800--2000 A colors of the A-F stars, which amounts to ~0.65 mags at a given B-V color index. The scatter is not caused by interstellar or circumstellar reddening. A convincing case can also be made against binarity and intrinsic variability due to pulsations of delta Sct origin. We find no correlation with established chromospheric and coronal proxies of convection, and thus no demonstrable link to the possible onset of convection among the A-F stars. The scatter is not instrumental. Approximately 0.4 mags of the scatter is shown to arise from individual differences in surface gravity as well as a moderate spread (factor of ~3) in heavy metal abundance and UV line blanketing. A dispersion of ~0.25 mags remains, which has no clear and obvious explanation. The most likely cause, we believe, is a residual imprecision in our correction for the spread in metal abundances. However, the existing data do not rule out possible contributions from intrinsic stellar variability or from differential UV line blanketing effects owing to a dispersion in microturbulent velocity.Comment: 40 pages, 14 figures, 1 table, AAS LaTex, to appear in The Astrophysical Journa

Nephrologists' perceptions regarding dialysis withdrawal and palliative care in Europe: lessons from a European Renal Best Practice survey

Background There is a variation in dialysis withdrawal rates, but reasons for this variation across European countries are largely unknown. We therefore surveyed nephrologists' perceptions of factors concerning dialysis withdrawal and palliative care and explored relationships between these perceptions and reports of whether withdrawal actually occurred in practice. Methods We developed a 33-item electronic survey, disseminated via an email blast to all European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) members. In our data analyses, we distinguished those respondents who reported occurrence from those reporting no dialysis withdrawal in their unit. With multilevel logistic regression, we investigated the association between respondents' characteristics and perceptions and whether they reported occurrence of dialysis withdrawal or not. Results Five hundred and twenty-eight nephrologists from 45 countries completed the questionnaire; 42% reported occurrence of withdrawal in their unit in the past year, and 56% perceived that stopping life-prolonging treatment in terminally ill patients was allowed. Few respondents reported presence in their unit of protocols on withdrawal decision making (7%) or palliative care (10%) or the common involvement of a geriatrician in withdrawal decisions (10%). The majority stated that palliative care had not been part of their core curriculum (74%) and that they had not recently attended continuous medical education sessions on this topic (73%). Respondents from Eastern and Southern Europe had a 42 and 40% lower probability, respectively, of reporting withdrawal compared with those from North European countries. Working in a public centre [odds ratio (OR), 2.41; 95% confidence interval (CI), 1.36-4.25] and respondents' perception that stopping life-prolonging treatment in terminally ill patients was allowed (OR, 1.96; 95% CI, 1.23-3.12), that withdrawal decisions were commonly shared between doctor and patient (OR, 1.97; 95% CI, 1.26-3.08) and that palliative care was reimbursed (OR, 1.81; 95% CI, 1.16-2.83) increased the odds of reporting occurrence of withdrawal. Conclusion Reports of dialysis withdrawal occurrence varied between European countries. Occurrence reports were more likely if respondents worked in a public centre, if stopping life-prolonging treatments was perceived as allowed, if withdrawal decisions were considered shared between doctors and patients and if reimbursement of palliative care was believed to be in place. There is room for improvement regarding protocols on withdrawal and palliative care processes and regarding nephrologists' training and education on end-of-life car