ABSTRACT
BACKGROUND: The World Health Organization leads a global strategy to promote the initiation and maintenance of breast-feeding. Existing literature shows that education and supportive interventions, both for breast-feeding mothers as well as for healthcare professionals, can increase the proportion of women that use exclusive breast-feeding, however, more evidence is needed on the effectiveness of group interventions. METHODS: This study involves a community-based cluster randomised trial conducted at Primary Healthcare Centres in the Community of Madrid (Spain). The project aims to evaluate the effectiveness of an educational group intervention performed by primary healthcare professionals in increasing the proportion of mother-infant pairs using exclusive breastfeeding at six months compared to routine practice. The number of patients required will be 432 (216 in each arm). All mother-infant pairs using exclusive breastfeeding that seek care or information at healthcare centres will be included, as long as the infant is not older than four weeks, and the mother has used exclusive breastfeeding in the last 24 h and who gives consent to participate. The main response variable is mother-infant pairs using exclusive breast-feeding at six months. Main effectiveness will be analysed by comparing the proportion of mother-infant pairs using exclusive breast-feeding at six months between the intervention group and the control group. All statistical tests will be performed with intention-to-treat. The estimation will be adjusted using an explanatory logistic regression model. A survival analysis will be used to compare the two groups using the log-rank test to assess the effect of the intervention on the duration of breastfeeding. The control of potential confounding variables will be performed through the construction of Cox regression models. DISCUSSION: We must implement strategies with scientific evidence to improve the percentage of exclusive breast-feeding at six months in our environment as established by the WHO. Group education is an instrument used by professionals in Primary Care that favours the acquisition of skills and modification of already-acquired behaviour, all making it a potential method of choice to improve rates of exclusive breast-feeding in this period. TRIAL REGISTRATION: The trial was registered with ClinicalTrials.gov under code number NCT01869920 (Date of registration: June 3, 2013).
Subject(s)
Breast Feeding , Delivery of Health Care/methods , Education, Nonprofessional/methods , Group Processes , Primary Health Care/methods , Adult , Breast Feeding/methods , Breast Feeding/psychology , Breast Feeding/statistics & numerical data , Female , Humans , Infant, Newborn , Motivation , Outcome Assessment, Health Care , Program EvaluationABSTRACT
Deterministic Boolean networks are a type of discrete dynamical systems widely used in the modeling of genetic networks. The dynamics of such systems is characterized by the local activation functions and the update schedule, i.e., the order in which the nodes are updated. In this paper, we address the problem of knowing the different dynamics of a Boolean network when the update schedule is changed. We begin by proving that the problem of the existence of a pair of update schedules with different dynamics is NP-complete. However, we show that certain structural properties of the interaction diagraph are sufficient for guaranteeing distinct dynamics of a network. In [1] the authors define equivalence classes which have the property that all the update schedules of a given class yield the same dynamics. In order to determine the dynamics associated to a network, we develop an algorithm to efficiently enumerate the above equivalence classes by selecting a representative update schedule for each class with a minimum number of blocks. Finally, we run this algorithm on the well known Arabidopsis thaliana network to determine the full spectrum of its different dynamics.
Subject(s)
Algorithms , Computational Biology/methods , Models, Theoretical , Neural Networks, ComputerABSTRACT
Intestinal tuberculosis is rare compared to other forms of the disease. A review of the last 10 years in a General University hospital identified 21 cases diagnosed at autopsy and 8 during life. Most patients were males, older than 30 years of age, alcoholics and originating in southern Chile. Evidence of concomitant pulmonary tuberculosis was frequent. Disease was located most commonly at the ileum and cecum, and surgery was needed in a high proportion of cases. Hepatic cirrhosis and lymphopenia were common findings in autopsy patients.
Subject(s)
Tuberculosis, Gastrointestinal/pathology , Adult , Antitubercular Agents/adverse effects , Autopsy , Female , Humans , Intestinal Obstruction/etiology , Intestinal Perforation/etiology , Male , Middle Aged , Retrospective Studies , Tuberculosis, Gastrointestinal/complicationsABSTRACT
Arterial blood gases were monitored in ten patients undergoing laparoscopy for diagnostic or sterilization procedure. During constant volume of ventilation, mean arterial co2 tension rose approximately 5 torr following insufflation of the peritoneal cavity with carbon dioxide. Arterial pH changes correlated well with arterial Pco2 changes. There was no significant change of oxygen tension in these patients.
