Factors associated with early cessation of breastfeeding in women with gestational diabetes mellitus

AimTo determine factors associated with early cessation of breastfeeding (≤3 months) in women with recent gestational diabetes mellitus (GDM).MethodsA cross-sectional online survey of women aged ≥18 years, diagnosed with GDM in 2010 and registered with the National Diabetes Services Scheme in Australia. The 59 questions examined breastfeeding duration, intention, attitudes, exclusivity and support.Results738 women completed the survey (15% response rate). Data was analysed for 729 eligible respondents. Of these 97% reported ‘ever’ breastfeeding and 19% had breastfed for ≤3 months. Cessation of breastfeeding at or before 3 months was associated with breastfeeding problems at home [adjusted odds ratio 8.01, 95% confidence interval (4.57, 14.05)], return to work prior to three months [OR 3.39 (95% CI 1.53, 7.55)], inadequate breastfeeding support [OR 1.88 (95% CI 1.10, 3.22)], caesarean delivery [OR 1.70 (95% CI 1.04, 2.76)], low socioeconomic status (SEIFA 1 unit increase) [OR 0.89 (95% CI 0.81, 0.97)] and BMI (2 unit increase) [OR 1.08 (95% CI 1.01, 1.57)]. Being married or de facto [OR 0.14 (95% CI 0.03, 0.62)] was a protective against early cessation of breastfeeding.ConclusionStrategies to improve breastfeeding duration in women with GDM need to address those most at risk of early cessation and provide appropriate postpartum breastfeeding support in this group.     

The Frisch–Waugh–Lovell theorem for the lasso and the ridge regression

The Frisch–Waugh–Lovell (FWL) (partitioned regression) theorem is essential in regression analysis. This is partly because it is quite useful to derive theoretical results. The lasso regression and the ridge regression, both of which are penalized least-squares regressions, have become popular statistical techniques. This article describes that the FWL theorem remains valid for these penalized least-squares regressions. More precisely, we demonstrate that the covariates corresponding to unpenalized regression parameters in these penalized least-squares regression can be projected out. Some other results related to the FWL theorem in such penalized least-squares regressions are also presented.     

A simulation study of methods for selecting subgroup‐specific doses in phase 1 trials

Patient heterogeneity may complicate dose‐finding in phase 1 clinical trials if the dose‐toxicity curves differ between subgroups. Conducting separate trials within subgroups may lead to infeasibly small sample sizes in subgroups having low prevalence. Alternatively,it is not obvious how to conduct a single trial while accounting for heterogeneity. To address this problem,we consider a generalization of the continual reassessment method on the basis of a hierarchical Bayesian dose‐toxicity model that borrows strength between subgroups under the assumption that the subgroups are exchangeable. We evaluate a design using this model that includes subgroup‐specific dose selection and safety rules. A simulation study is presented that includes comparison of this method to 3 alternative approaches,on the basis of nonhierarchical models,that make different types of assumptions about within‐subgroup dose‐toxicity curves. The simulations show that the hierarchical model‐based method is recommended in settings where the dose‐toxicity curves are exchangeable between subgroups. We present practical guidelines for application and provide computer programs for trial simulation and conduct.     

Minimum variance unbiased estimation of stress–strength reliability under bivariate normal and its comparisons

In many industrial and natural phenomena, we need the probability that a component is smaller than the other component. Under a stress–strength model, this is reliability of an item. Under independent setup, there are different approaches for the estimation of such reliability. Here, estimation is considered under the dependent case. Under bi-variate setup uniformly minimum variance unbiased estimator is obtained. Also comparison with available estimator based on Maximum Likelihood Estimate (MLE) is done through Mean Square Error (MSE) and bias. Also these are compared by computing L₁ distance between their distribution functions. From this idea and numerical computations, UMVUE appears to be good.     

Lurking Behavior in Online Psychosocial Discussion Forums: Theoretical Perspectives and Implications for Practice

Improving outcomes of telebehavioral psychoeducation requires rethinking program design when delivered wholly or partially for self-directed participation. Discussion forum participation often follows the “90-9-1 Rule” where 90% of participants lurk, rather than contribute content. A theoretical perspective on the behavior can help explain its adaptive functions, as well as the threats that this behavior poses to the lurker. Implications for practice require program redesign that actively links individual skills training and group-based discussion. The proposed linking design can synergize individual and group participation to support the development of mutual aid, as well as greater interaction with psychoeducation content and materials.     

高校应用型计算机人才培养的实践教学研究——以琼州学院为例

以应用型人才培养为目标,说明了计算机课程实践环节的重要性,通过调整教学速度,达到增加学生学习兴趣的目的,通过对实践环节的重新设计,提高了学生的计算机基础实践能力,增加了校企合作环节,达到了培养的要求。     

社会主义生态文明建设的重要内容: 生态消费模式

当前,我国消费伴随着经济的快速发展日益被异化为“病态式消费”模式,这使得国民经济的协调发展遭到了严重破坏,甚至生态系统也面临着崩溃的危险。我国新富群体缺乏正确的消费观念,加上西方消费主义影响,引发了诸多的社会问题。实践证明,只有树立正确的消费观念、克制消费欲望、调整消费行为,才能建立生态消费模式,才能符合社会主义生态文明的要求,实现人与自然的协调发展。     

句式中介词结构漂移的语篇语用解释

句式具有语篇功能,语篇功能制约句法结构。文章主要考察了否定句、假设句、条件句、时间状语从句句中介词结构的分布,这些句式在语篇中具有非现实性,不在叙述的主线上,属于背景信息,具有低及物性的特点。介词结构在小句中的漂移受及物性决定,高及物性的小句中介词结构位于动词后,而低及物性的小句中介词结构位于动词前。通过溯因推理,介词结构在这些特殊句式中只能处在主谓之间,处在动词之后不合语法。研究发现,真实语篇语料的考察证实了这一推测。     

我国新型农村社会养老保险经济支持能力研究

老农保的失败让人们对新农保充满期待的同时也存有几分担忧,他们担心农民的经济承受力。更怕财政不堪重负。为坚定领导层试点、推广新农保的信心和决心,加快新农保发展步伐,本文在测算新型农村社会养老保险的经济负担的基础上,对农民个人和政府两方面的经济支持能力进行分析,认为只要制度设计合理,农民个人和政府是有能力承担这部分支出的。     

Diabetes education program for people with type 2 diabetes: An international perspective

BackgroundIn the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, and changes in food habits has increased the risk of non-communicable diseases especially diabetes mellitus. Diabetes complications can be prevented if the glycemic status of patients with diabetes is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range.ObjectiveThis study aimed at measuring the effect of diabetes educational intervention program for patients suffering from type 2 diabetes attending the Diabetes Clinic in Tulkarim Directorate of Health.MethodsA short duration observational study involving pre- and post-test educational intervention program was carried out on a relatively small number of type 2 diabetes patients at the Diabetes Clinic in Tulkarim Directorate of Health. In total, 215 patients attended a group-based 4 h educational intervention session about diabetes. The program included explaining diabetes mellitus-symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking cessation, periodic investigations, home monitoring and importance of physical activity. Knowledge evaluation questionnaire were evaluated pre- and post-study. Anthropometric measurements such as body weight (WT), body mass index (BMI) and laboratory tests such as fasting blood glucose (FBG), hemoglobin A1C (HbA1c), cholesterol (Chol), and triglycerides (TG) were measured both at the beginning and at the end of the study. Significance of the results was assessed by paired t-test at 95% confidence interval.ResultsThe participant’s mean age was 51.07 that ranged between 31 and 70 years. For a total of 215 participants, 41.4% were males and 58.6% were females. The mean weight before educational intervention was 80.81 ± 14.95 kg (82.6 kg for males and 79.5 kg for females) that decreased to 78.9 ± 14.33 kg (81.1 kg for males and 77.3 kg for females) after educational intervention program. The BMI also decreased significantly after educational intervention. The mean fasting blood sugar was 188.65 ± 71.45 mg/dL before educational intervention that decreased to 177.7 ± 66.11 mg/dL after the educational intervention (p = 0.049). The mean glycosylated hemoglobin was 8.57 ± 1.21 before educational intervention that decreased to 7.95 ± 1.42 after educational intervention. The mean value of cholesterol before educational intervention was 183.27 ± 37.74 mg/dL that decreased to 169.57 ± 34.23 mg/dL after educational intervention. The mean triglycerides value decreased after educational intervention from 209.85 ± 171.04 mg/dL to 183.28 ± 152.4 mg/dL (p = 0.025). The mean score of knowledge questionnaire before educational intervention was 60.6 ± 20.65 that increased to 78.1 ± 13.4 after conducting educational intervention.ConclusionsDiabetes education was found to be effective on BMI, FBG, HbA1c, Chol, TG, and knowledge.RecommendationsDiabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient’s family, diabetes care team, community, and decision makers in the education process.