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Purpose This study aims to (1) describe the health-related quality of life (HRQoL) outcomes experienced by children born very preterm (28–31 weeks’ gestation) and extremely preterm ( Methods This investigation was based on data for 3687 children born at ™ GCS scores. A mediation analysis that applied generalised structural equation modelling explored the association between potential mediators and PedsQL™ GCS scores. Results The multi-level OLS regression (fully adjusted model) revealed that birth at ™ GCS score of 0.35, 3.71 and 5.87, respectively. The mediation analysis revealed that the indirect effects of BPD and severe non-respiratory morbidity on the total PedsQL™ GCS score translated into decrements of 1.73 and 17.56, respectively, at Conclusion The findings suggest that HRQoL is particularly impaired by extremely preterm birth and the concomitant complications of preterm birth such as BPD and severe non-respiratory morbidity.

La filosofía de gestión constituye el soporte de la estructura en las organizaciones, dado que una construcción adecuada facilita que los procesos administrativos, estén alineados para el cumplimiento de los objetivos trazados. Así, el propósito del artículo es determinar los elementos de la filosofía de gestión que constituyen el soporte de la competitividad en empresas de construcción en el departamento del Atlántico-Colombia. Se asumió un enfoque positivista-cuantitativo, investigación analítica, diseño no experimental, transversal, de campo; aplicando un cuestionario, escala actitudinal con 22 reactivos, validado por expertos y confiabilidad alfa de Crombach de 0.89, a una muestra intencional de 27 empresas que hacen vida en el sector. Estadísticamente, se utilizó el programa SPSS versión 21, aplicando análisis de Varianza, para realizar comparaciones entre indicadores o dimensiones dentro de un instrumento multidimensional. Se aplicó la prueba Post Hoc de Tukey y “t” student, para obtener medias por indicador, dimensiones, variable y su posicionamiento. Encontrando, que se cumplen el establecimiento de la visión, misión, valores y objetivos, con debilidades en el desempeño de éstos últimos impactando en la competitividad. Concluyendo, en la relevancia de implementar acciones administrativas gerenciales tendentes al fortalecimiento de los objetivos en la filosofía de gestión en las empresas estudiadas.

IMPORTANCE: People conceived using assisted reproductive technology (ART) make up an increasing proportion of the world's population. OBJECTIVE: To investigate the association of ART conception with offspring growth and adiposity from infancy to early adulthood in a large multicohort study. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used a prespecified coordinated analysis across 26 European, Asia-Pacific, and North American population-based cohort studies that included people born between 1984 and 2018, with mean ages at assessment of growth and adiposity outcomes from 0.6 months to 27.4 years. Data were analyzed between November 2019 and February 2022. EXPOSURES: Conception by ART (mostly in vitro fertilization, intracytoplasmic sperm injection, and embryo transfer) vs natural conception (NC; without any medically assisted reproduction). MAIN OUTCOMES AND MEASURES: The main outcomes were length / height, weight, and body mass index (BMI; calculated as weight in kilograms divided by height in meters squared). Each cohort was analyzed separately with adjustment for maternal BMI, age, smoking, education, parity, and ethnicity and offspring sex and age. Results were combined in random effects meta-analysis for 13 age groups. RESULTS: Up to 158 066 offspring (4329 conceived by ART) were included in each age-group meta-analysis, with between 47.6% to 60.6% females in each cohort. Compared with offspring who were NC, offspring conceived via ART were shorter, lighter, and thinner from infancy to early adolescence, with differences largest at the youngest ages and attenuating with older child age. For example, adjusted mean differences in offspring weight were -0.27 (95% CI, -0.39 to -0.16) SD units at age younger than 3 months, -0.16 (95% CI, -0.22 to -0.09) SD units at age 17 to 23 months, -0.07 (95% CI, -0.10 to -0.04) SD units at age 6 to 9 years, and -0.02 (95% CI, -0.15 to 0.12) SD units at age 14 to 17 years. Smaller offspring size was limited to individuals conceived by fresh but not frozen embryo transfer compared with those who were NC (eg, difference in weight at age 4 to 5 years was -0.14 [95% CI, -0.20 to -0.07] SD units for fresh embryo transfer vs NC and 0.00 [95% CI, -0.15 to 0.15] SD units for frozen embryo transfer vs NC). More marked differences were seen for body fat measurements, and there was imprecise evidence that offspring conceived by ART developed greater adiposity by early adulthood (eg, ART vs NC difference in fat mass index at age older than 17 years: 0.23 [95% CI, -0.04 to 0.50] SD units). CONCLUSIONS AND RELEVANCE: These findings suggest that people conceiving or conceived by ART can be reassured that differences in early growth and adiposity are small and no longer evident by late adolescence.

Objective Robson's Ten Group Classification System (TGCS) creates clinically relevant sub‐groups for monitoring caesarean birth rates. This study assesses whether this classification can be derived from routine data in Europe and uses it to analyse national caesarean rates. Design Observational study using routine data. Setting Twenty‐seven EU member states plus Iceland, Norway, Switzerland and the UK. Population All births at ≥22 weeks of gestational age in 2015. Methods National statistical offices and medical birth registers derived numbers of caesarean births in TGCS groups. Main outcome measures Overall caesarean rate, prevalence and caesarean rates in each of the TGCS groups. Results Of 31 countries, 18 were able to provide data on the TGCS groups, with UK data available only from Northern Ireland. Caesarean birth rates ranged from 16.1 to 56.9%. Countries providing TGCS data had lower caesarean rates than countries without data (25.8% versus 32.9%, P = 0.04). Countries with higher caesarean rates tended to have higher rates in all TGCS groups. Substantial heterogeneity was observed, however, especially for groups 5 (previous caesarean section), 6, 7 (nulliparous/multiparous breech) and 10 (singleton cephalic preterm). The differences in percentages of abnormal lies, group 9, illustrate potential misclassification arising from unstandardised definitions. Conclusions Although further validation of data quality is needed, using TGCS in Europe provides valuable comparator and baseline data for benchmarking and surveillance. Higher caesarean rates in countries unable to construct the TGCS suggest that effective routine information systems may be an indicator of a country's investment in implementing evidence‐based caesarean policies. Tweetable abstract Many European countries can provide Robson's Ten‐Group Classification to improve caesarean rate comparisons., Tweetable abstract Many European countries can provide Robson's Ten‐Group Classification to improve caesarean rate comparisons.

Contextualização: A retenção de participantes em estudos de coorte é um grande desafio. É necessária uma melhor compreensão de todos os elementos envolvidos nos fenómenos de participação e de atrito em contextos par‑ ticulares para desenvolver estratégias de retenção eficazes. O estudo visou alcançar uma compreensão aprofundada da retenção de participantes em coortes longitudinais centrando‑se tanto nas perspetivas de participantes investigados quanto de investigadores, em três cenários sociogeográficos e culturais diversos. Métodos: Este estudo utilizou uma triangulação de métodos multi‑situados para recolher dados sobre estudos de coorte de crianças nascidas com menos de 32 semanas de gestação na Dinamarca, Itália e Portugal. Incluiu uma metodologia visual colaborativa, grupos focais e entrevistas individuais semi‑‑dirigidas com atores chave envolvidos nas coortes (pais, staff, profissionais de saúde, investigadores). Foi recolhida uma amostra intencional de 48 ato‑ res chave (n=13 na Dinamarca; n=13 na Itália; n=22 em Portugal). Na análise foi aplicada uma triangulação de análise temática fenomenológica com análise do discurso. Foram identificados, em vários níveis e etapas, elementos situacionais contextualmente específicos e transversais envolvidos nos fenómenos de participação e atrito nestas coortes infantis. Resultados: Principais resultados incluíram: desafios situacionais que afetam o potencial e amplitude de possibilidades na implementação estratégica (ambiente geopolítico, mudanças sociais, modelos de financiamento da inves‑ tigação); elementos situacionais relacionados com estratégias particulares que atuam como dissuasores (questionários postais) e facilitadores (múltiplas estratégias flexíveis, lembretes, interação regular); motivações maiores para aceitar participar e continuar na coorte (altruísmo/solidariedade e gratidão/ /sentido do dever de retribuir); principais desmotivadores para participar em ondas de acompanhamento/follow‑up (fraco elo de ligação ao estudo, retorno de informação insuficiente); perceção parental de entrelaçamento dos acompanhamentos clínico e da investigação que atua quer como facilitador quer Conclusões: A utilização de uma abordagem multi‑situada, focada na interação da experiência vivida dos indivíduos envolvidos, foi da maior utilidade para compreender a variabilidade da participação sob diferentes implementações estratégicas em contexto. Foram identificados elementos situacionais contextualmente específicos e transversais que atuam como fatores influenciadores na participação e no atrito das coortes como dissuasor. info:eu-repo/semantics/publishedVersion

Objective: To investigate the variation in severe neonatal morbidity among very preterm (VPT) infants across European regions and whether morbidity rates are higher in regions with low compared with high mortality rates.Design: Area-based cohort study of all births before 32 weeks of gestational age.Setting: 16 regions in 11 European countries in 2011/2012.Patients: Survivors to discharge from neonatal care (n=6422).Main outcome measures: Severe neonatal morbidity was defined as intraventricular haemorrhage grades III and IV, cystic periventricular leukomalacia, surgical necrotizing enterocolitis and retinopathy of prematurity grades >= 3. A secondary outcome included severe bronchopulmonary dysplasia (BPD), data available in 14 regions. Common definitions for neonatal morbidities were established before data abstraction from medical records. Regional severe neonatal morbidity rates were correlated with regional in-hospital mortality rates for live births after adjustment on maternal and neonatal characteristics.Results: 10.6% of survivors had a severe neonatal morbidity without severe BPD (regional range 6.4%23.5%) and 13.8% including severe BPD (regional range 10.0%-23.5%). Adjusted inhospital mortality was 13.7% (regional range 8.4%-18.8%). Differences between regions remained significant after consideration of maternal and neonatal characteristics (P< 0.001) and severe neonatal morbidity rates were not correlated with mortality rates (P= 0.50).Conclusion: Severe neonatal morbidity rates for VPT survivors varied widely across European regions and were independent of mortality rates.

Background: Retention of participants in cohort studies is a major challenge. A better understanding of all elements involved in participation and attrition phenomena in particular settings is needed to develop effective retention strategies. The study aimed to achieve an in-depth understanding of participant retention in longitudinal cohorts focusing on participants’ and researcher’s perspectives, across three diverse socio-geographic and cultural settings. Methods: This study used a triangulation of multi-situated methods to collect data on cohort studies of children born with less than 32 weeks of gestation in Denmark, Italy and Portugal. It included focus groups and individual semi-driven interviewing with involved key actors (i.e. parents, staff, healthcare professionals, researchers) and a collaborative visual methodology. A purposive sample of 48 key actors (n = 13 in Denmark; n = 13 in Italy; n = 22 in Portugal) was collected. A triangulation of phenomenological thematic analysis with discourse analysis was applied. Cross-contextual and context-specific situational elements involved in participation and attrition phenomena in these child cohorts were identified at various levels and stages. Results: Main findings included: situational challenges affecting potential and range of possibilities for implementation strategies (geopolitical environment, societal changes, research funding models); situational elements related to particular strategies acting as deterrents (postal questionnaires) and facilitators (multiple flexible strategies, reminders, regular interaction); main motivations to enrol and participate (altruism/solidarity and gratitude/sense of duty to reciprocate); main motivational deterrents to participate to follow-up waves (lack of bonding, insufficient feedback); entanglement of clinical and research follow-up as facilitator and deterrent. Conclusions: The multi-situated approach used, addressing the interplay of the lived experience of individuals, was of most value to understand participation variability under different implemented strategies in-context. Cross-contextual and context-specific situational elements that have been influential factors towards participation and attrition in the cohorts were identified. RECAP Preterm-WP6 QS Work Group Group authorship collaboration RECAP Preterm-WP6 QS Work Group: Sandra CS Marques (CRIA, Instituto Universitário de Lisboa, Portugal; EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal), Julia Doetsch (EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal), Raquel Teixeira (EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal); Georgia Abate, Grazia Colombo and Marina Cuttini (Clinical Care and Management Innovation Research Area, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy); Anne Brødsgaard (Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Denmark; Department of Public Health, HEALTH, Aarhus University, Denmark); Elizabeth S Draper (Department of Health Sciences, College of Life Sciences, University of Leicester, United Kingdom); Sylvia van der Pal and Ilona Wildeman (TNO-Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek, The Netherlands); Pernille Pedersen (Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Denmark); Kari Anne I Evensen, Ann-Mari Brubakk and Marit S Indredavik (Department of Clinical and Molecular Medicine, NTNU–Norwegian University of Science and Technology, Norway); Eero Kajantie (Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Finland; Children’s Hospital, Helsinki University Hospital and University of Helsinki, Finland; Department of Clinical and Molecular Medicine, NTNU-Norwegian University of Science and Technology, Norway); Eeva Virtanen (Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland); Jo Lebeer; Vicky Hennissen; Iemke Sarrechia (Department FAMPOP Family Medicine & Population Health, Faculty of Medicine & Health Sciences University of Antwerp, Belgium) and Henrique Barros (Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal; EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal). All named researchers contributed to the development of the study protocol and/or its local implementation.

Background & aims: Extra-uterine growth restriction (EUGR) is common among very preterm (VPT) infants and has been associated with impaired neurodevelopment. Some research suggests that adverse effects of EUGR may be more severe in boys. We investigated EUGR and neurodevelopment at 2 years of corrected age (CA) by sex in a VPT birth cohort. Methods: Data come from a population-based cohort of children born

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A infeção pode ocorrer em qualquer idade, mas são as pessoas mais velhas ou com doenças crónicas que estão em maior risco de complicações graves e morte devido à doença. O SARS-CoV-2 pode-se transmitir de pessoa para pessoa por gotículas respiratórias, contacto direto com secreções infetadas e por aerossóis gerados por procedimentos terapêuticos, não havendo ainda evidência clara de transmissão por via aérea. As gotículas podem ainda depositar-se em superfícies ou objetos que se transmitem após contacto direto das mãos seguindo-se de contactos com a boca, nariz ou olhos. Neste sentido e tratando-se de um problema de saúde pública, é necessário um olhar preocupado para com um grupo muito específico da população, com dificuldades especiais e condições que podem facilitar a transmissão da doença: as pessoas em situação de sem-abrigo.

The objective of this work was to evaluate the application of kinetin associated with nitrogen in coverage on the agronomic characteristics and soybean yield. In the 2016/2017 harvest, a 6x2 factorial scheme was used, six doses of kinetin (0; 0.30; 0.60; 0.90; 1.20; 1.50 g ha−1) and two doses of N (20 and 40 kg ha−1) and in the 2017/2018 harvest, factorial scheme 5x2 was used, five doses of kinetin (0; 0.25; 0.75; 1.00; 1.25 g ha−1) and two doses of N (20 and 40 kg ha−1). Agronomic plant height characteristics, first pod insertion height, number of grains per plant, number of pods per plant, number of grains per pod, number of grains per pod, hundred-grain mass and grain yield were evaluated. The use of N alone and associated with kinetin increased the number of pods and grains in the 2016/2017 harvest. In the 2017/2018 crop, kinetin caused a reduction of 8.9% at plant height and N caused an increase in plant height and first pod insertion and reduced the number of pods and grains per plant, grains per pods and productivity. Made available in DSpace on 2021-01-23T09:10:16Z (GMT). No. of bitstreams: 1 asrhets-2020-2.pdf: 747573 bytes, checksum: bad7e2379b5f9ed669cd3930b049459b (MD5) Previous issue date: 2020