Safety and efficacy of antenatal milk expressing for women with diabetes in pregnancy: protocol for a randomised controlled trial

Many maternity providers recommend that women with diabetes in pregnancy express and store breast milk in late pregnancy so breast milk is available after birth, given (1) infants of these women are at increased risk of hypoglycaemia in the first 24 h of life; and (2) the delay in lactogenesis II compared with women without diabetes that increases their infant's risk of receiving infant formula. The Diabetes and Antenatal Milk Expressing (DAME) trial will establish whether advising women with diabetes in pregnancy (pre-existing or gestational) to express breast milk from 36 weeks gestation increases the proportion of infants who require admission to special or neonatal intensive care units (SCN/NICU) compared with infants of women receiving standard care. Secondary outcomes include birth gestation, breastfeeding outcomes and economic impact.

Identifying affinity classes of inorganic materials binding sequences via a graph-based model

Rapid advances in bionanotechnology have recently generated growing interest in identifying peptides that bind to inorganic materials and classifying them based on their inorganic material affinities. However, there are some distinct characteristics of inorganic materials binding sequence data that limit the performance of many widely-used classification methods when applied to this problem. In this paper, we propose a novel framework to predict the affinity classes of peptide sequences with respect to an associated inorganic material. We first generate a large set of simulated peptide sequences based on an amino acid transition matrix tailored for the specific inorganic material. Then the probability of test sequences belonging to a specific affinity class is calculated by minimizing an objective function. In addition, the objective function is minimized through iterative propagation of probability estimates among sequences and sequence clusters. Results of computational experiments on two real inorganic material binding sequence data sets show that the proposed framework is highly effective for identifying the affinity classes of inorganic material binding sequences. Moreover, the experiments on the structural classification of proteins (SCOP) data set shows that the proposed framework is general and can be applied to traditional protein sequences.

The inter-relationship between depressive, anxiety and stress symptoms in fathers during the antenatal period

Objective: The aim of this study was to examine whether depressive symptoms predict anxiety and stress or whether anxiety and stress precede depressive symptoms in fathers during the antenatal period. Background: The findings of previous studies suggest that there is an association between paternal depression, anxiety and stress during the antenatal period. However, the temporal inter-relationship between these variables has yet to be investigated. Method: Data were collected from 150 expectant couples at approximately 18, 25 and 33 weeks’ gestation. Results: After accounting for the relative stability of depression, anxiety and stress over time, for men higher levels of anxiety earlier in pregnancy predicted higher levels of depression and stress in middle pregnancy, which predicted higher depression during late pregnancy. A similar relationship remained after partialling out the effects of partner’s depression, perceived social support and sleep quality. Further analyses also revealed significant differences in the manifestation of distress symptoms between men and women, but not between first-time and non-first-time fathers. Conclusion: Our findings indicated a possible inter-relationship between depression, anxiety and stress for men antenatally. Our findings also showed that men who reported elevated depression, anxiety and stress earlier in the antenatal period also reported elevated symptomology at later time points. Finally, the current findings revealed that antenatal paternal stress may play a key role in the development of depression and anxiety later in pregnancy. Therefore, it may be important to screen for early levels of antenatal stress in men, as well as depression and anxiety.

Chlamydia screening for pregnant women aged 16-25 years attending an antenatal service: a cost-effectiveness study

OBJECTIVE: Determine the cost-effectiveness of screening all pregnant women aged 16-25 years for chlamydia compared with selective screening or no screening. DESIGN: Cost effectiveness based on a decision model. SETTING: Antenatal clinics in Australia. SAMPLE: Pregnant women, aged 16-25 years. METHODS: Using clinical data from a previous study, and outcomes data from the literature, we modelled the short-term perinatal (12-month time horizon) incremental direct costs and outcomes from a government (as the primary third-party funder) perspective for chlamydia screening. Costs were derived from the Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, and average cost-weights reported for hospitalisations classified according to the Australian refined diagnosis-related groups. MAIN OUTCOME MEASURES: Direct costs of screening and managing chlamydia complications, number of chlamydia cases detected and treated, and the incremental cost-effectiveness ratios were estimated and subjected to sensitivity analyses. RESULTS: Assuming a chlamydia prevalence rate of 3%, screening all antenatal women aged 16-25 years at their first antenatal visit compared with no screening was $34,931 per quality-adjusted life-years gained. Screening all women could result in cost savings when chlamydia prevalence was higher than 11%. The incremental cost-effectiveness ratios were most sensitive to the assumed prevalence of chlamydia, the probability of pelvic inflammatory disease, the utility weight of a positive chlamydia test and the cost of the chlamydia test and doctor's appointment. CONCLUSION: From an Australian government perspective, chlamydia screening of all women aged 16-25 years old during one antenatal visit was likely to be cost-effective compared with no screening or selective screening, especially with increasing chlamydia prevalence. TWEETABLE ABSTRACT: Chlamydia screening for all pregnant women aged 16-25 years during an antenatal visit is cost effective.

Antenatal dietary patterns and depressive symptoms during pregnancy and early post-partum

Perinatal depression is a debilitating disorder experienced during pregnancy and/or the first year post-partum. Recently, maternal dietary intake during pregnancy has emerged as a possible area of intervention for the prevention of mental disorders in women and their offspring. However, the relationship between antenatal diet quality and perinatal depressive symptoms remains poorly understood. The current study explored the predictive role of antenatal diet quality for antenatal and post-natal depressive symptoms. Pregnant women (n = 167) were recruited between February 2010 and December 2011. Women completed the Edinburgh Postnatal Depression Scale at time 1 [T1, mean weeks gestation = 16.70, standard deviation (SD) = 0.91], time 2 (T2, mean weeks gestation = 32.89, SD = 0.89) and time 3 (T3, mean weeks post-partum = 13.51, SD = 1.97) and a food frequency questionnaire at T1 and T2. Diet quality was determined by extracting dietary patterns via principal components analysis. Two dietary patterns were identified: 'healthy' (including fruit, vegetables, fish and whole grains) and 'unhealthy' (including sweets, refined grains, high-energy drinks and fast foods). Associations between dietary patterns and depressive symptoms were investigated by path analyses. While both 'healthy' and 'unhealthy' path models showed good fit, only one significant association consistent with study hypotheses was found, an 'unhealthy' diet was associated with increased depressive symptoms at 32 weeks gestation. Given that this association was cross-sectional, it was not possible to make any firm conclusions about the predictive nature of either dietary patterns or depressive symptoms. Dietary intervention studies or larger prospective studies are therefore recommended.

Strategies to Increase Course Completion Rates in Lower-Level, High-Enrollment Classes

With an increase in performance-based funding based on credit hours, retention, and graduation rates, administrators seek strategies to increase course completion rates in low-level, high-enrollment courses. This report examines pedagogical strategies implemented within the classroom to increase course completion rates in gateway courses. It also examines how administrators identify qualities that indicate experience and motivation to improve students’ success when hiring new faculty.

De bar em bar : identidade masculina e auto-segregação entre homens de classes populares

Este trabalho é resultado de uma pesquisa etnográfica a respeito da construção social de identidade masculina em classes populares. O universo escolhido são os bares localizados no bairro Cidade Baixa em Porto Alegre, os quais são denominados como butecos, locais onde a freqüência é predominantemente masculina. Em um bairro ocupado por diferentes grupos sociais, estes homens encontram-se auto-segregados. São locais onde investem grande parte de seu tempo lúdico, nos intervalos do trabalho ou antes do retorno ao espaço doméstico. A partir de suas diferentes falas, busco compreender os dilemas e atitudes constituidores de sua identidade de gênero.

Concepção de uma biblioteca de classes para sistemas de manufatura

Neste trabalho é proposta uma biblioteca de classes para sistemas de manufatura que visa facilitar a construção de modelos de simulação, permitindo o reuso e a agilizando a modelagaem. A principal característica deste trabalho é sua abordagem que difere da maioria dos trabalhos correlatos na área. Ela baseia-se na utilização de conceitos de produção bastante conhecidos atualemnte, como os roteiros e atividades de produção. Isto permite a criação de novas simulações muito mais rapidamente do que em outras metodologias, já que não são necessárias traduções compelxas entre a realidade e as aplicações simuladas. A biblioteca desenvolvida foi validade com a aplicação dos conceitos à modelagem de uma linha de produção de pontas de eixo para tratores, produzidos pela empresa Pigozzi S/A. ALém disso, o trabalho discute a possibilidade de integração entre a biblioteca de classes proposta e a ferramente de simulação de sistemas de manufatura Automod. A simulação do estudo de caso da linha de produção de pontas de eixo, modelada tanto no Automod quanto na biblioteca de classes proposta, permitiu uma comparação quantitativa, o que viabilizou a validação este trabalho.