RAISE (Raising Infants to Be Smart Eaters) Pilot Study

Background: Many of the complex determinants of obesity originate during infancy when small changes in the environment can permanently influence appetite, behavior, and energy metabolism. Parent feeding style ("how" rather than "what" to feed) has emerged as a potentially important factor in early obesity prevention. Objectives: (1) To assess the feasibility of conducting a brief responsive feeding education intervention by public health nurses during routine well-baby visits. (2) To assess whether this intervention affects parents' attitudes and behavior related to responsive feeding. Methods: Prospective, nonrandomized, comparative pilot study conducted in two communities. Intervention participants were exposed to enhanced responsive feeding education by public health nurses at routine well-baby visits from 0 to 18 months along with wall posters, handouts, automated text messages and tangible takeaways. Parent knowledge and behavior were measured using the Infant Feeding Style Questionnaire and the Toddler Development Index. Feasibility and acceptability were assessed by patients and nurses through open text feedback forms and mid-point and exit interviews. Results: Recruitment (18 intervention; 9 control) and retention fell below targets. Average adherence to protocol by nurses from 0 to 12 months was 89%. Delivery of the intervention was feasible and acceptable, but the additional research-related tasks were challenging in a busy clinical setting. Parents found the different formats and information new and helpful. There was a trend toward less nonresponsive (pressuring, restrictive, laissez-faire) feeding practices in the intervention group. Conclusions: This pilot study demonstrated encouraging results related to overall feasibility and effect on parent feeding style.

Intensifying rehabilitation of combined sewer systems using trenchless technology in combination with low impact development and green infrastructure

Throughout Europe, there is a considerable need for investment in the upgrade of sewer systems - due to three main factors: ageing infrastructure, climate change and urban population growth. The need for investments is expected to grow significantly in the years ahead. Trenchless rehabilitation (no-dig) of sewer pipelines is a cost-efficient and environmental friendly method for upgrading existing pipelines with sufficient capacity. This study examines the possibility of applying no-dig to combined sewer systems (CS) with insufficient capacity. In this study, a concept assessment methodology that combines the analytical approaches from stormwater and sewer system assessments is presented. The methodology was tested on a case area that was part of an environmental project in Oslo, Norway. Three alternative concepts were examined; A0: no-dig and low impact development (LID), A1: no-dig, LID and green infrastructure (GI), and A2: CS up-sizing using open-cut methods. The study concludes that CS with insufficient capacity can be rehabilitated using no-dig if LID and GI. The combination of no-dig and LID reduces costs considerably but does involve the risk of damages from uncontrolled surface runoff. The main risk-reduction measure is the development of GI as an integrated stormwater management system that requires cross-sector collaboration within municipalities.