RESUMEN
OBJECTIVE: To compare growth, feeding tolerance, and clinical and biochemical evaluations in human milk-fed preterm infants randomized to receive either an acidified or a nonacidified liquid human milk fortifier. STUDY DESIGN: This prospective, controlled, parallel, multicenter growth and tolerance study included 164 preterm infants (≤32 weeks of gestation, birth weight 700-1500 g) who were randomized to acidified or nonacidified liquid human milk fortifier from study day 1, the first day of fortification, through study day 29 or until hospital discharge. RESULTS: There was no difference in the primary outcome of weight gain from study days 1 to 29 (acidified liquid human milk fortifier, 16.4 ± 0.4 g/kg/day; nonacidified liquid human milk fortifier, 16.9 ± 0.4 g/kg/day). However, in both the intention-to-treat and the protocol evaluable analyses, infants fed nonacidified liquid human milk fortifier had significantly greater weight gain from study days 1 to 15 (17.9 g/kg/day vs 15.2 g/kg/day; P = .001). Infants fed with acidified liquid human milk fortifier received more protein (4.26 vs g/kg/day 4.11 g/kg/day, P = .0099) yet had lower blood urea nitrogen values (P = .010). The group fed acidified liquid human milk fortifier had more vomiting (10.3% vs 2.4%; P = .018), gastric residuals (12.8% vs 3.7%; P = .022), and metabolic acidosis (27% vs 5%; P < .001) in the intention-to-treat analysis and more abdominal distension (14.0% vs 1.7%; P = .015) in the protocol evaluable analysis. CONCLUSIONS: Infants fed an acidified liquid human milk fortifier had higher rates of metabolic acidosis and poor feeding tolerance compared with infants fed a nonacidified liquid human milk fortifier. Initial weight gain was poorer with the acidified liquid human milk fortifier. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02307760.
Asunto(s)
Alimentos Fortificados , Recien Nacido Prematuro/crecimiento & desarrollo , Leche Humana , Acidosis/epidemiología , Nitrógeno de la Urea Sanguínea , Femenino , Alimentos Fortificados/efectos adversos , Humanos , Concentración de Iones de Hidrógeno , Recién Nacido , Masculino , Estudios Prospectivos , Vómitos/epidemiología , Aumento de PesoRESUMEN
Associations between domestic violence exposure and violent and prosocial behavior were tested in a sample of Colombian adolescents, with attention to impulsivity and substance use problems as mediators of these associations. A representative sample of 1,152 school youths and a convenience group of 148 juvenile offenders aged 11-19 years participated. Results using structural equation modeling showed indirect effects of impulsivity and substance use problems between family violence (i.e., exposure to interparental violence) and violent behavior. Maltreatment (i.e., harsh parenting) was directly associated with violent behavior, though impulsivity and substance use problems also mediated this relation. Maltreatment directly and inversely contributed to prosocial behavior but there was no evidence of mediation. Results are discussed in terms of cognitive and behavioral factors that explain violent and prosocial behavior among Colombian youths. Limitations and implications for prevention are described.
Asunto(s)
Conducta del Adolescente , Violencia Doméstica/psicología , Delincuencia Juvenil/psicología , Conducta Social , Adolescente , Adulto , Altruismo , Niño , Maltrato a los Niños/psicología , Colombia , Femenino , Humanos , Conducta Impulsiva , Masculino , Modelos Psicológicos , Factores de Riesgo , Trastornos Relacionados con Sustancias/psicología , Violencia/psicologíaRESUMEN
Nesse estudo, duas duplas de criancas severamente retardadas foram ensinadas a pressionar uma chave para conseguir doces como recompensa. Consequentemente, os sujeitos foram expostos duas vezes ao feedback verbal de cooperacao e ao feedback verbal de cooperacao pareado a uma contingencia de cooperacao (CC ou backcratch contingency) para pressionar a chave. Observou-se que as interacoes sociais de olhar e verbalizar (como efeitos colaterais) foram maiores nas fases de feedback verbal de cooperacao pareado com a contingencia do que nas fases imediatamente precedentes ao feedback verbal de cooperacao isolado. Nao ocorreram interacoes indesejaveis de agressao ou gritos. Nao foi observada generalizacao para outro ambiente e este problema e discutido juntamente a outros parametros determinantes de interacoes produzidas pela contingencia de cooperacao backcratch.