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BACKGROUND: Hypertensive disorders of pregnancy (HDP) generate complications and are one of the principal causes of maternal, foetal, and neonatal mortality worldwide. It has been observed that in pregnancies with HDP, the incidence of foetuses small for their gestational age (SGA) is twice as high as that in noncomplicated pregnancies. In women with HDP, the identification of foetuses (SGA) is substantially important, as management and follow-up are determined by this information. OBJECTIVE: The objective of this study was to evaluate whether the INTERGROWTH-21st method or customized birthweight references better identify newborns with an abnormal nutritional status resulting from HDP. METHOD: A comparative analysis study was designed with two diagnostic methods for the prediction of neonatal nutritional status in pregnancies with HDP. The performance of both methods in identifying neonatal malnutrition (defined by a neonatal body mass index < 10(th) centile or a ponderal index < 10(th) centile) was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio, Youden's index and probability ratios. RESULTS: The study included 226 pregnant women diagnosed with HDP. The customized method identified 45 foetuses as small for gestational age (19.9%), while the INTERGROWTH-21st method identified 27 newborns with SGA (11.9%). The difference between proportions was statistically significant (p < 0.01). Using body mass index (< 10(th) centile) as a measure of nutritional status, newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR: 4.87 (95% CI: 1.86-12.77) vs. 3.75 (95% CI: 1.49-9.43)) (DOR: 5.56 (95% CI: 1.82-16.98) vs. 4.84 (95% CI: 1.51-15.54)) Even when using Ponderal index (< 10(th) centile), newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR 2.37 (95% CI: 1.11-5.05) vs. 1.68 (95% CI: 0.70-4.03))(DOR 2.62 (95% CI: 1.00-6.87) vs. 1.90 (95% CI: 0.61-5.92)). CONCLUSION: In pregnant women with HDP, the predictive ability of the customized foetal growth curves to identify neonatal malnutrition appears to surpass that of INTERGROWTH-21st.

The Alpert–Stein Factor Separation Methodology (FS) method has been utilized in the study of the biophysical response to changes in the environment to assess the relative contribution of different atmospheric factors to the biological system. In this chapter we will discuss crop simulation and land surface model-based assessments of the sensitivity to past and future changes in climatic conditions: increasing CO2, soil moisture, temperature and radiative conditions, and crop management procedures (irrigation). FS is applied to discern specific contributions to plant responses by single variables or combinations of environmental conditions. Our FS analysis has shown that it is important to understand that biological responses are inherently dependent on multiple variables in the natural world and should not be limited to assessments of single specific parameters. Introduction In this chapter we demonstrate how the FS analysis technique is a useful tool for crop–climate change (crop-clim) studies. Important interactions between the atmosphere and biophysical processes occur under land surface and atmospheric carbon dioxide (CO2) level changes. We employ the Alpert–Stein FS Methodology (Stein and Alpert, 1993; Alpert, 1997) to investigate the direct as well as the interactive effects of soil moisture, temperature, and radiative changes on the direct effects of CO2 doubling for different land-use/vegetation types, including agricultural production.

El artículo presenta la planeación y el desarrollo de actividades de enfermería en salud mental, desarrolladas durante un período de diez años consecutivos, a fin de transmitir al futuro profesional el enfoque preventivo en la atención al individuo, la familia y la comunidad.

Background. E. coli strains producing specific virulence factors are frequently cited as causes of pediatric diarrhea in developing areas, although many well children from the same areas are colonized with these organisms. The role of these Escherichia coli in day-care center (DCC)-associated diarrhea in the United States has not been evaluated. Methods. A cohort of 112 DCC attendees from 5 DCC in urban New Orleans were followed longitudinally with demographic data, biweekly routine stool samples and additional stool samples with episodes of diarrhea. E. coli isolates were routinely saved; diarrhea stool samples were tested to detect enterotoxigenic, enterohemorrhagic and enteroadherent strains; and the prevalence of these E. coli in children with and without diarrhea was investigated. Results. During 225 child months of observation 21 episodes of diarrhea were documented and microbiologic data were available for 18. HEp-2 cell enteroadherent E. coli [mostly enteroaggregative (EAggEC) pattern] were identified in 6 of 18 (33.3%) diarrhea cases vs. 6 of 36 (16.6%) age-matched controls. However, the prevalence of EAggEC was very DCC-specific, with EAggEC found in 12 of 22 routine specimens from a DCC with recent EAggEC-related diarrhea vs. 0 of 11 routine specimens from age-matched children in another DCC without EAggEC-related diarrhea (P = 0.002). Enterotoxigenic E. coli were uncommon in both ill and well children, and no enterohemorrhagic E. coli were detected. Conclusion. EAggEC were commonly isolated from children with and without diarrhea in certain DCC settings, although we cannot determine whether these strains caused diarrhea. Diarrhea-producing E. coli were not associated with diarrhea in this DCC population.

To study the behaviour of fibre reinforced composite laminates under in-plane complex stress states a biaxial loading frame has been developed. Using four independent servo-hydraulic actuators a cruciform type specimen is biaxially loaded in its plane. For obtaining reliable biaxial failure data the design of the cruciform specimen is of paramount importance. Finite element simulations of the cruciform specimen in combination with experiments using DIC for strain determination has led to the proposal of an optimized geometry which was used to obtain strength data at different loading ratio's. For the identification of the in-plane orthotropic elastic constants an inverse method is presented. The full field displacements and strains are identified by digital image correlation technique and compared with finite element strain results. The engineering constants are unknown parameters in the finite element model. Starting from initial values, these parameters are updated tillthe computed strain field matches the experimental strain field.

El Instituto Colombiano de Bienestar Familiar I.C.B.F. presentó el 28 de febrero de 1982 el programa de Hogares Comunitarios, orientado a brindar atención al niño en edad preescolar. El programa se implementa a través de la madre comunitaria, que ha sido previamente capacitada para así cumplir con los objetivos de propiciar un desarrollo físico y sicosocial adecuado en el proceso de atención y de educación del niño pre-escolar.