Coupling as a trade-off in an Enterprise Service Bus

Traditionally, integration problems between IT systems were solved by point-to-point connections. These point-to-point connections pose issues with scalability, reliability, and flexibility. To overcome these issues, companies typically invest in Enterprise Application Integration (EAI) using an Enterprise Service Bus (ESB) to integrate the IT systems through a central middleware infrastructure. EAI promises improvement of scalability, reliability, and flexibility by implementing loosely coupled integration solutions to realise loosely coupled IT systems. By wrongly implementing EAI on an ESB IT systems may still be tightly coupled and the issues with point-to-point connections could be recreated on the ESB. Currently there is no out-of-the-box solution to identify the integration solution where tight coupling causes these issues. The goal of this research is to investigate an approach to identify the coupling state in an Enterprise Service Bus and identify the integration solutions on an ESB which have a negative impact on the quality attributes due to tight coupling. The first step in the approach is applying a set of properties on the integration solutions to identify their coupling state. Manually identifying the coupling state is labour intensive, so it is automated by implementing a prototype with the Eclipse MoDisco framework. The second step in the approach is evaluating a trade-off between the risk of being in a certain coupling state and the efficiency loss of migrating to a less risky coupling state. With the outcome of the trade-off it can be ascertained whether or not it is beneficial to migrate to a different coupling state. The result of the approach is a list of integration solutions for which it would be beneficial to migrate to a different coupling state. This gives a concrete measure to be able to determine which integration solutions need to be improved to strive for the optimal balance between quality and the effort needed to realise quality. The approach was validated using the ESB implementation of a large European airport as a case study

Towards an integrated psychoneurophysiological approach of irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by recurrent abdominal pain or discomfort accompanied by disturbed bowel habits. It is among the most frequently occurring functional bowel syndromes, but the pathophysiology is poorly understood. A variety of mechanisms have been proposed in symptom generation, including enhanced visceral sensitivity, disturbed intestinal motility, autonomic dysfunction, mucosal inflammation, altered immune activity, altered processing of afferent sensory information, and psychological disturbances. These alterations probably reflect dysfunction at different levels of the brain-gut axis. The concept of the brain-gut axis as a model to improve our understanding of the pathophysiology of IBS has been the basis of research in IBS over the last decades and the framework for this thesis. In IBS patients, we demonstrate altered autonomic function by decreased baroreflex sensitivity, changes in proximal and distal gut hormone secretion, impaired postprandial rectocolonic reflex, and increased frequency of a high-producer TNF-alpha gene Single Nucleotide Polymorphism (SNP), compared to healthy individuals. Furthermore, results from a randomized controlled trial favour relaxation training over standard medical care for the treatment of IBS. Finally, we test the validity of a previously published comprehensive working model of IBS, based on the brain-gut axis.J.E. Jurriaanse Stichting; several pharmaceutical industries.UBL - phd migration 201

Maternal satisfaction with professional health care for excessive infant crying: does it meet maternal needs?

Education and Child Studie

Targeting food parenting practices to prevent early child obesity risk requires a different approach in families with a lower socioeconomic position

Education and Child Studie

Two Patients with Extremely Elevated Tumor Markers: Where Is the Malignancy?

Serum tumor markers are useful to evaluate a cancer's response to treatment, for early detection of cancer relapse, and, in some cases, to diagnose malignancy. In this paper, we present two patients with significantly elevated serum tumor markers without evidence of malignant disease. An 18-year-old patient suffering from autoimmune hepatitis had markedly increased alpha-fetoprotein (aFP) levels (2,002 μg/L; normal <10 ug/L). Extensive imaging showed no signs of hepatocellular carcinoma or other cancer, and treatment with Prednisone led to rapid normalization of both liver enzymes and aFP. The second patient, a 60-year-old female with painless jaundice due to biliary stone disease, had very high serum levels of CA19-9 (18,000 kU/L, normal <27 kU/L). Liver biochemistry and serum CA19-9 concentration decreased to almost normal values (45 kU/L) after biliary stenting. These cases demonstrate that serum tumor markers can be elevated in benign disease and are therefore not appropriate to diagnose cancer

Child care in times of COVID-19:Predictors of distress in Dutch children and parents when re-entering center-based child care After a 2-month lockdown

As a consequence of the outbreak of the Coronavirus Disease 2019 (COVID-19) child care facilities all over the world were temporarily closed to minimize the spread of the virus. In Netherlands, the first closure lasted for almost 2 months. The return to the child care center after this significant interruption was expected to be challenging, because earlier studies demonstrated that transitions into child care can be stressful for both children and their parents. The current paper retrospectively examined the distress of Dutch children (aged 0–4) and their parents during the first 2 weeks after the reopening of child care centers, and what factors accounted for individual differences in distress. In total, 694 parents filled out an online questionnaire about stress during closure and distress after the reopening of child care centers. Furthermore, questions regarding several demographic variables and child care characteristics were included, as well as questionnaires measuring child temperament, parental separation anxiety, and parental perception of the child care quality. Results showed that younger children and children with parents scoring higher on separation anxiety experienced more distress after the reopening, as reported by parents. Furthermore, children were more distressed upon return when they attended the child care center for less hours per week after the reopening, experienced less stress during closure, and grew up in a one-parent family. With regard to parental distress after the reopening, we found that parents scoring higher on separation anxiety and fear of COVID-19 experienced more distress. Moreover, parents experiencing less stress during closure and mothers were more distressed when the child returned to the child care center. Finally, concurrent child and parental distress after reopening were positively related. The results of the current study may help professional caregivers to identify which children and parents benefit from extra support when children return to the child care center after an interruption. Especially the role that parental separation anxiety played in predicting both child and parental distress deserves attention. More research is required in order to study the underlying mechanisms of these associations and to design appropriate interventions

Young children's cortisol levels at out-of-home child care: a meta-analysis

Education and Child StudiesEducation and Child Studie

Child care in times of COVID-19: predictors of distress in Dutch children and parents when re-entering center-based child care after a 2-month lockdown

As a consequence of the outbreak of the Coronavirus Disease 2019 (COVID-19) child care facilities all over the world were temporarily closed to minimize the spread of the virus. In Netherlands, the first closure lasted for almost 2 months. The return to the child care center after this significant interruption was expected to be challenging, because earlier studies demonstrated that transitions into child care can be stressful for both children and their parents. The current paper retrospectively examined the distress of Dutch children (aged 0-4) and their parents during the first 2 weeks after the reopening of child care centers, and what factors accounted for individual differences in distress. In total, 694 parents filled out an online questionnaire about stress during closure and distress after the reopening of child care centers. Furthermore, questions regarding several demographic variables and child care characteristics were included, as well as questionnaires measuring child temperament, parental separation anxiety, and parental perception of the child care quality. Results showed that younger children and children with parents scoring higher on separation anxiety experienced more distress after the reopening, as reported by parents. Furthermore, children were more distressed upon return when they attended the child care center for less hours per week after the reopening, experienced less stress during closure, and grew up in a one-parent family. With regard to parental distress after the reopening, we found that parents scoring higher on separation anxiety and fear of COVID-19 experienced more distress. Moreover, parents experiencing less stress during closure and mothers were more distressed when the child returned to the child care center. Finally, concurrent child and parental distress after reopening were positively related. The results of the current study may help professional caregivers to identify which children and parents benefit from extra support when children return to the child care center after an interruption. Especially the role that parental separation anxiety played in predicting both child and parental distress deserves attention. More research is required in order to study the underlying mechanisms of these associations and to design appropriate interventions.Education and Child Studie

Baby's first bites: association between observed maternal feeding behavior and infant vegetable intake and liking

Positive experiences with the introduction of solid food in infancy may lead to positive associations with feeding in both parent and infant. During this transitional period, parental feeding behavior and infant eating behavior might mutually reinforce each other. A feeding style that is found to be associated with positive child eating behavior, is sensitive feeding. In the present study we tested bidirectional prospective relations between mother and infant behavior in a cross-lagged model using observations of two feeds on two consecutive days on which the first bites of solid food were offered. The sample consisted of 246 first-time mothers and their infants, whose feeding interactions were videotaped during two home visits. Maternal sensitive feeding behavior (consisting of responsiveness to child feeding cues, general sensitivity and non-intrusiveness) and maternal positive and negative affect were coded. In addition, infant vegetable intake was weighed and vegetable liking was reported by mother. Results showed at least some stability of maternal feeding behavior and infant vegetable intake and liking from the first to the second feed. In addition, during the second feed maternal sensitive feeding and positive affect were associated with infant vegetable intake (r=.34 and r=.14) and liking (r=.33 and r=.39). These associations were mostly absent during the first feed. Finally, infant vegetable liking during the first feed positively predicted maternal sensitive feeding behavior during the second feed (β=.25), suggesting that the infant's first response might influence maternal behavior. Taken together, mother and infant seem more attuned during the second feed than during the first feed. Future studies might include multiple observations over a longer time period, or micro-coding. Such insights can inform prevention programs focusing on optimizing feeding experiences during the weaning period.Education and Child Studie