Early determinants of overweight and obesity at 5 years old in preschoolers from inner of Minas Gerais, Brazil

Introduction: Brazil is experiencing a nutritional transition characterized by a reduction in the prevalence of nutritional deficits and an increase in overweight and obesity, not only in adults but also in children and adolescents.Objectives: This study was designed to evaluate the factors associated with overweight and obesity in Brazilian 5-year-old preschoolers.Methods: A cross-sectional study of a cohort of 232 preschoolers born in Diamantina/Minas Gerais, Brazil, was undertaken. the data, including socioeconomic status, anthropometry, diet, previous history of the preschoolers and family history, were collected between July of 2009 and July of 2010. To identify the factors associated with overweight and obesity, a logistic regression and a hierarchical model were undertaken.Results: Overweight and obesity occurred in 17.2% of the preschoolers. After adjusting for mother's obesity, per capita income, protective food intake, weight gain at age 0-4 months and time spent playing, the factors associated with overweight and obesity that reached statistical significance were mother's obesity [OR = 3.12 (95% CI 1.41-6.91), P = 0.01], weight gain of more than 0.85 kg/month in the first four months of life [OR = 2.16 (95% CI 1.01-4.64), P = 0.041 and lower per capita income [OR = 0.32 (95 %CI 0.13-0.79), P = 0.01].Conclusion: the results show that more weight gain during the first four months of life and being born of mothers with obesity increased the odds of overweight/obesity in the preschoolers, while lower per capita income was a protective factor.

Pressure support versus T-tube for weaning from mechanical ventilation in adults

BackgroundMechanical ventilation is important in caring for patients with critical illness. Clinical complications, increased mortality, and high costs of health care are associated with prolonged ventilatory support or premature discontinuation of mechanical ventilation. Weaning refers to the process of gradually or abruptly withdrawing mechanical ventilation. the weaning process begins after partial or complete resolution of the underlying pathophysiology precipitating respiratory failure and ends with weaning success (successful extubation in intubated patients or permanent withdrawal of ventilatory support in tracheostomized patients).ObjectivesTo evaluate the effectiveness and safety of two strategies, a T-tube and pressure support ventilation, for weaning adult patients with respiratory failure that required invasive mechanical ventilation for at least 24 hours, measuring weaning success and other clinically important outcomes.Search methodsWe searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 6); MEDLINE (via PubMed) (1966 to June 2012); EMBASE (January 1980 to June 2012); LILACS (1986 to June 2012); CINAHL (1982 to June 2012); SciELO (from 1997 to August 2012); thesis repository of CAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior) (http://capesdw.capes.gov.br/capesdw/) (August 2012); and Current Controlled Trials (August 2012).We reran the search in December 2013. We will deal with any studies of interest when we update the review.Selection criteriaWe included randomized controlled trials (RCTs) that compared a T-tube with pressure support (PS) for the conduct of spontaneous breathing trials and as methods of gradual weaning of adult patients with respiratory failure of various aetiologies who received invasive mechanical ventilation for at least 24 hours.Data collection and analysisTwo authors extracted data and assessed the methodological quality of the included studies. Meta-analyses using the random-effects model were conducted for nine outcomes. Relative risk (RR) and mean difference (MD) or standardized mean difference (SMD) were used to estimate the treatment effect, with 95% confidence intervals (CI).Main resultsWe included nine RCTs with 1208 patients; 622 patients were randomized to a PS spontaneous breathing trial (SBT) and 586 to a T-tube SBT. the studies were classified into three categories of weaning: simple, difficult, and prolonged. Four studies placed patients in two categories of weaning. Pressure support ventilation (PSV) and a T-tube were used directly as SBTs in four studies (844 patients, 69.9% of the sample). in 186 patients (15.4%) both interventions were used along with gradual weaning from mechanical ventilation; the PS was gradually decreased, twice a day, until it was minimal and periods with a T-tube were gradually increased to two and eight hours for patients with difficult and prolonged weaning. in two studies (14.7% of patients) the PS was lowered to 2 to 4 cm H2O and 3 to 5 cm H2O based on ventilatory parameters until the minimal PS levels were reached. PS was then compared to the trial with the T-tube (TT).We identified 33 different reported outcomes in the included studies; we took 14 of them into consideration and performed meta-analyses on nine. With regard to the sequence of allocation generation, allocation concealment, selective reporting and attrition bias, no study presented a high risk of bias. We found no clear evidence of a difference between PS and TT for weaning success (RR 1.07, 95% CI 0.97 to 1.17, 9 studies, low quality of evidence), intensive care unit (ICU) mortality (RR 0.81, 95% CI 0.53 to 1.23, 5 studies, low quality of evidence), reintubation (RR 0.92, 95% CI 0.66 to 1.26, 7 studies, low quality evidence), ICU and long-term weaning unit (LWU) length of stay (MD -7.08 days, 95% CI -16.26 to 2.1, 2 studies, low quality of evidence) and pneumonia (RR 0.67, 95% CI 0.08 to 5.85, 2 studies, low quality of evidence). PS was significantly superior to the TT for successful SBTs (RR 1.09, 95% CI 1.02 to 1.17, 4 studies, moderate quality of evidence). Four studies reported on weaning duration, however we were unable to combined the study data because of differences in how the studies presented their data. One study was at high risk of other bias and four studies were at high risk for detection bias. Three studies reported that the weaning duration was shorter with PS, and in one study the duration was shorter in patients with a TT.Authors' conclusionsTo date, we have found evidence of generally low quality from studies comparing pressure support ventilation (PSV) and with a T-tube. the effects on weaning success, ICU mortality, reintubation, ICU and LWU length of stay, and pneumonia were imprecise. However, PSV was more effective than a T-tube for successful spontaneous breathing trials (SBTs) among patients with simple weaning. Based on the findings of single trials, three studies presented a shorter weaning duration in the group undergoing PS SBT, however a fourth study found a shorter weaning duration with a T-tube.

A multidisciplinary approach for puzzling over fish connectivity in the Mediterranean Sea: The role of early life history stages of red mullet (Mullus barbatus)

Integrating connectivity patterns into marine ecosystem management is a fundamental step, specially for stock subjected to the combined impacts of human activities (overfishing, habitat degradation, etc.) and climate changes. Thus, management of marine resources must incorporates the spatial scales over which the populations are connected. Notwithstanding, studying these dynamics remains a crucial and hard task and the predictions of the temporal and spatial patterns of these mechanisms are still particularly challenging. This thesis aims to puzzle over the red mullet Mullus barbatus population connectivity in the Western Mediterranean Sea, by implementing a multidisciplinary approach. Otolith sclerochronology, larval dispersal modelling and genetic techniques were gathered in this study. More particularly, this research project focused on early life history stages of red mullet and their role in the characterization of connectivity dynamics. The results show that M. barbatus larval dispersal distances can reach a range of 200 km. The differences in early life traits (i.e. PLD, spawning and settlement dates) observed between various areas of the Western Mediterranean Sea suggest a certain level of larval patchiness, likely due to the occurrence of different spawning pulses during the reproductive period. The dispersal of individuals across distant areas, even not significant in demographic terms, is accountable for the maintenance of the genetic flow among different demes. Fluctuations in the level of exchange among different areas, due to the variability of the source-sink dynamics, could have major implications in the population connectivity patterns. These findings highlight the reliability of combining several approaches and represent a benchmark for the definition of a proper resource management, with considerable engagements in effectively assuring the beneficial effects of the existent and future conservation strategies.

Understanding nurses’ decision-making when managing weaning from mechanical ventilation: a study of novice and experienced critical care nurses in Scotland and Greece.

Aim and objectives To examine how nurses collect and use cues from respiratory assessment to inform their decisions as they wean patients from ventilatory support. Background Prompt and accurate identification of the patient's ability to sustain reduction of ventilatory support has the potential to increase the likelihood of successful weaning. Nurses' information processing during the weaning from mechanical ventilation has not been well-described. Design A descriptive ethnographic study exploring critical care nurses' decision-making processes when weaning mechanically ventilated patients from ventilatory support in the real setting. Methods Novice and expert Scottish and Greek nurses from two tertiary intensive care units were observed in real practice of weaning mechanical ventilation and were invited to participate in reflective interviews near the end of their shift. Data were analysed thematically using concept maps based on information processing theory. Ethics approval and informed consent were obtained. Results Scottish and Greek critical care nurses acquired patient-centred objective physiological and subjective information from respiratory assessment and previous knowledge of the patient, which they clustered around seven concepts descriptive of the patient's ability to wean. Less experienced nurses required more encounters of cues to attain the concepts with certainty. Subjective criteria were intuitively derived from previous knowledge of patients' responses to changes of ventilatory support. All nurses used focusing decision-making strategies to select and group cues in order to categorise information with certainty and reduce the mental strain of the decision task. Conclusions Nurses used patient-centred information to make a judgment about the patients' ability to wean. Decision-making strategies that involve categorisation of patient-centred information can be taught in bespoke educational programmes for mechanical ventilation and weaning. Relevance to clinical practice Advanced clinical reasoning skills and accurate detection of cues in respiratory assessment by critical care nurses will ensure optimum patient management in weaning mechanical ventilation

Novelty and Habituation: the Driving Forces in Early Stage Learning for Developmental Robotics

Meng, Q., & Lee, M. (2005). Novelty and Habituation: the Driving Forces in Early Stage Learning for Developmental Robotics. Wermter, S., Palm, G., & Elshaw, M. (Eds.), In: Biomimetic Neural Learning for Intelligent Robots: Intelligent Systems, Cognitive Robotics, and Neuroscience. (pp. 315-332). (Lecture Notes in Computer Science). Springer Berlin Heidelberg.

Growth of Motor Coordination in Early Robot Learning

M. H. Lee and Q. Meng, Growth of Motor Coordination in Early Robot Learning, IJCAI-05, 2005.

Novelty and Habituation: the Driving Forces in Early Stage Learning for Developmental Robotics

Q. Meng and M. H. Lee, Novelty and Habituation: the Driving Forces in Early Stage Learning for Developmental Robotics, AI-Workshop on NeuroBotics, University of Ulm, Germany. September 2004.

Early-Holocene environments in the Wadi Faynan, Jordan

Hunt, C. Elrishi, H. Gilbertson, D. Grattan, J. McLaren, S. Pyatt, B. Rushworth, G. Barker, G. Early-Holocene environments in the Wadi Faynan, Jordan. The Holocene. 2004. 14,6 pp 921-930

Early library management systems in the UK

A 5-minute clip from a 1975 video on Bath University Library has been incorporated as slide 21 of this PowerPoint. The video was produced by the author to show library and information science students details of a library with a computer-based cataloguing and circulation system. To make sure that the video clip functions correctly within the presentation, please make sure that you have downloaded both the presentation (.ppt file) and the video (.wmv file) into the same directory. To activate the video move the cursor to the middle of Slide 21 (i.e. the screen that says Bath University) and then click the mouse.

Error-driven active learning in growing radial basis function networks for early robot learning

Q. Meng and M.H. Lee, 'Error-driven active learning in growing radial basis function networks for early robot learning', 2006 IEEE International Conference on Robotics and Automation (IEEE ICRA 2006), 2984-90, Orlando, Florida, USA.

Psychologically Inspired Sensory-Motor Development in Early Robot Learning

Lee, M., Meng, Q. (2005). Psychologically Inspired Sensory-Motor Development in Early Robot Learning. International Journal of Advanced Robotic Systems, 325-334.

Psychologically Inspired Sensory-Motor Development in Early Robot Learning

M.H. Lee and Q. Meng, 'Psychologically Inspired Sensory-Motor Development in Early Robot Learning', in proceedings of Towards Autonomous Robotic Systems 2005 (TAROS-05), Nehmzow, U., Melhuish, C. and Witkowski, M. (Eds.), Imperial College London, 157-163, September 2005. See published version: http://hdl.handle.net/2160/485

The mechanical and thermal structure of Mercury's early lithosphere

Cook, Anthony; Watters, T.R.; Schultz, R.A.; Robinson, M.S., (2002) 'The mechanical and thermal structure of Mercury's early lithosphere', Geophysical Research Letters 29(11) pp.1542 RAE2008

Dynamics of learner affective development in early FLL

Affective learner factors were first considered as a cause of success in language learning. This was followed by a change in approach and recently authors (e.g., Edelenbos, Johnstone, & Kubanek, 2006) have considered them an important outcome, especially in early foreign language learning (FLL). Current research into affective learner factors in early FLL tries to catch the developmental aspects too, and studies are emerging that take a contextual view as well. This paper describes a study on affective characteristics of young FL learners that combines the developmental and contextual perspectives. Using the case study methodology the author analyses the affective profiles of three young learners of English as a foreign language who were followed for 4 years. The analyses are done taking into account their immediate language learning environment, home support, out-of-school exposure to English and language achievement. The findings suggest that affective learner factors contribute to the dynamic complexity of early FLL.