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Search Results: 1 - 10 of 36593 matches for " Ellen van der Gaag "
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Diminishing demandingness of parents; children with recurrent infections  [PDF]
Ellen van der Gaag, Miriam Münow
Health (Health) , 2012, DOI: 10.4236/health.2012.48077
Abstract: Background and Method: Parenting and parenting styles are in favor of authoritative parents compared with non-authoritative parents. These parents display higher levels of both responsiveness and demandingness. We studied the aspect of demandingness using a questionnaire aimed at children aged between 1 and 4 years. 82 Children with recurrent respiratory infections (RRI) and 399 control children were included. Results: Parents of RRI children regulated the quantitative dietary intake of their child less; likewise they gave less stimulation to their children to eat. They also taught their children less on what they can or cannot touch and they argued more with their children (all p < 0.05). However, when it comes to simple rules like watching television or not, the parents of RRI children were very clear. There were however no differences in rules about television watching, computer time or bedtimes. Conclusions: Our study shows that parents of children with RRI are less demanding in complex pedagogic situations that ask for creativity from the parents. However, they are demanding with respect to simple rules. We found no child factors that could explain why children give their parents a hard time. We hypothesize that the parents of RRI children could be less capable of handling complex pedagogic situations (even more complicated by the infections) instead of being unwilling.
Hospitalization Can Correct Behavioral Feeding Disorders in Children by Resetting the Pedagogic Climate  [PDF]
Ellen van der Gaag, Miriam Münow
Open Journal of Pediatrics (OJPed) , 2014, DOI: 10.4236/ojped.2014.42019

Background: Behavioral feeding disorders are common among children, which sometimes become progressive, and consequently, children may refuse to eat anything. Parents have lots of difficulties to reset such a disturbed eating pattern. The aim of this study was to perform an analysis of clinical intervention in behavioral feeding disorders in young children. Methods: We conducted a retrospective analysis of data of 28 children aged 1 - 9 years with behavioral feeding disorders. A pediatrician and pediatric social worker conducted the training in two groups: outpatient or inpatient setting. Both groups were treated with parental education and guidance. The inpatient group also had a temporarily (2 weeks) resetting of the pedagogic climate in a pediatric ward of a general hospital under guidance of a pediatric social worker. Results: Almost all parents were inconsistent in applying appropriate behavioral contingencies during meals. Eleven patients followed 8 months of outpatient treatment and 25 patients followed 2 weeks of inpatient treatment. The overall success rate of outpatient treatment after 2 weeks was 18%, and that of inpatient treatment after 8 months was 88%. The corrected relapse rates are 18% and 56% respectively after 6 months. Conclusion: Short clinical intervention in a structured pedagogic environment is a successful treatment in behavioral feeding disorders. Herewith, pediatricians have a powerful tool for treating behavioral feeding disorders by temporarily resetting and changing the pedagogic climate.

Upper respiratory tract infections in children: A normal stage or high parental concern?  [PDF]
Ellen J. Van Der Gaag, Nicole Van Droffelaar
Open Journal of Pediatrics (OJPed) , 2012, DOI: 10.4236/ojped.2012.23038
Abstract: Background: Families function less efficiently when one of the children suffers from illness. Upper respiratory tract infections (URTI) are common among children. Though the child may have no critical or serious health problem, the parents may frequently get worried and visit the general practitioner or pediatrician. Do children with URTI who visit the doctor frequently pass through a normal stage in childhood or are their parents more concerned than usual? Methods: A questionnaire was filled out for 76 children between 1 and 4 years of age. Two groups were created: a URTI group and a control group. Results: The URTI group suffered from these infections for 19.4 days a month, compared with 5.9 days in the control group. In addition, they also suffered from fever for a longer duration and used more antibiotics. The parents of these children were found to be more concerned, caused by a fear of a serious disease. They often keep their child at home and make their child consume more medicines. Conclusions: Parents of children with recurrent infections are found to be more concerned and a hypothesis of high parental concern and child's illness is discussed. Minimizing parental concern can therefore be a possible preventive treatment.
Subclinical Hypothyroidism in Children Can Normalize after Changes in Dietary Intake  [PDF]
Marjolein W. J. Kuiper, Ellen J. van der Gaag
Food and Nutrition Sciences (FNS) , 2012, DOI: 10.4236/fns.2012.33059
Abstract: Background: There is no effective treatment for children with subclinical hypothyroidism. The natural course of subclinical hypothyroidism shows a normalization rate of 41% for Thyroid Stimulating Hormone (TSH). Objective; The thyroid needs (among others) iron, iodine, and vitamin A for a proper thyroid hormone synthesis. We hypothesize that with a dietary change, more children can normalize their TSH. Design: In this case-control study, 54 children aged 1 - 14 years with subclinical hypothyroidism were divided into a diet group and a control group. The diet consisted of green vegetables, beef, full fat milk, and butter. The diet was followed for at least 3 months. A total of 27 patients comprised the diet group and 27 the control group. TSH, Free T4 (FT4), and Body Mass Index (BMI) were evaluated during the follow up. Results: By following this diet, TSH levels decreased significantly compared to when following the natural course. FT4 levels did not change during the follow up. The diet group realized a change of normalizing their TSH with a RR 2.8 (95% CI 1.45 - 5.61). There were no changes in BMI after following the diet. Conclusions: Even though our study population was small, we observed the association of a dietary change and normalization of TSH in children with subclinical hypothyroidism, without adverse effects.
The Teaspoon Method; A Simple Training Program for Feeding Disorders in High Functioning Autistic Children  [PDF]
Ellen J. Van Der Gaag, Marlou C. E. Snijders
Open Journal of Pediatrics (OJPed) , 2017, DOI: 10.4236/ojped.2017.72009
Abstract: Objective: About 90% of autistic children are known to have a selective feeding disorder. In particular, methods are lacking for stimulating self feeding and treating selective eating amongst school-aged and adolescent autistic children. We developed a simple training programme for paediatricians in a general hospital to improve the eating pattern of autistic children and decrease selectivity. Methods: The study is an experimental patient series. The instructions for the training were given in 15-minute sessions by a paediatrician with the use of social positive and negative reinforcements. The negative reinforcement was an avoidance situation. The training was performed with parental participation in the home environment of the child. Results and conclusion: In the before and after measurement, the quantitative intake of fruit, potatoes and vegetables increased significantly (p < 0.05). Food selectivity decreased, expressed by an increase in variation of consumed fruit, meat, potatoes and sandwich filling (p < 0.01). The costs of the training are low, and the children stay in their home environment.
Recurrent Upper Respiratory Tract Infections in Children;The Influence of Green Vegetables, Beef, Whole Milk and Butter  [PDF]
Loes G. H. Ten Velde, Jolien Leegsma, Ellen J. Van der Gaag
Food and Nutrition Sciences (FNS) , 2013, DOI: 10.4236/fns.2013.410A011

Background: Immunological mechanism and dietary nutrients are important mediators in the health of children. In this intervention study a dietary advice is given to children between 1 and 6 years of age with recurrent respiratory tract infections. Could a change in nutrient intake result in an altered clinical outcome? Design: In this prospective cohort study 61 children were included and evaluated at a paediatric outpatient clinic. The control group consisted of 32 children included at an infant welfare centre. The patient group followed the dietary advice (green vegetables, beef, whole milk, full-fat butter) for three months, in which parents filled out their dietary intake and health status on a daily basis. A follow up form was filled out by the parents 3 months after completion of the study period. For statistical analysis the programme SPSS version 15.0 was used. Results: In the patient group there was a statistical significant reduction in days with a respiratory infection (15.7 to 11.5 days a month), subfebrile temperature days (1.9 to 0.5 days a month) and febrile temperature days (1.0 to 0.7 days a month) compared to the control group. Also, antibiotic use decreased significantly. No significant changes were measured in body mass index. Conclusions: A change of diet towards green vegetables, beef, whole milk and full-fat butter has positive health effects in children. This diet may work by adding nutrients to optimize immunological mechanisms. There were no adverse effects and it can be utilized by general pediatricians and general practitioners.

Computing Probability Intervals Under Independency Constraints
Linda C. van der Gaag
Computer Science , 2013,
Abstract: Many AI researchers argue that probability theory is only capable of dealing with uncertainty in situations where a full specification of a joint probability distribution is available, and conclude that it is not suitable for application in knowledge-based systems. Probability intervals, however, constitute a means for expressing incompleteness of information. We present a method for computing such probability intervals for probabilities of interest from a partial specification of a joint probability distribution. Our method improves on earlier approaches by allowing for independency relationships between statistical variables to be exploited.
The Computational Complexity of Sensitivity Analysis and Parameter Tuning
Johan Kwisthout,Linda C. van der Gaag
Computer Science , 2012,
Abstract: While known algorithms for sensitivity analysis and parameter tuning in probabilistic networks have a running time that is exponential in the size of the network, the exact computational complexity of these problems has not been established as yet. In this paper we study several variants of the tuning problem and show that these problems are NPPP-complete in general. We further show that the problems remain NP-complete or PP-complete, for a number of restricted variants. These complexity results provide insight in whether or not recent achievements in sensitivity analysis and tuning can be extended to more general, practicable methods.
Sensitivity Analysis for Threshold Decision Making with Dynamic Networks
Theodore Charitos,Linda C. van der Gaag
Computer Science , 2012,
Abstract: The effect of inaccuracies in the parameters of a dynamic Bayesian network can be investigated by subjecting the network to a sensitivity analysis. Having detailed the resulting sensitivity functions in our previous work, we now study the effect of parameter inaccuracies on a recommended decision in view of a threshold decision-making model. We detail the effect of varying a single and multiple parameters from a conditional probability table and present a computational procedure for establishing bounds between which assessments for these parameters can be varied without inducing a change in the recommended decision. We illustrate the various concepts involved by means of a real-life dynamic network in the field of infectious disease.
Proceedings of the Twenty-Third Conference on Uncertainty in Artificial Intelligence (2007)
Ronald Parr,Linda S. van der Gaag
Computer Science , 2012,
Abstract: This is the Proceedings of the Twenty-Third Conference on Uncertainty in Artificial Intelligence, which was held in Vancouver, British Columbia, July 19 - 22 2007.
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