1,720,979 research outputs found
Preconception care for diabetic women for improving maternal and infant health
No full textBackground Infants born to mothers with pre-existing type I or type II diabetes mellitus are at greater risk of congenital anomalies, perinatal mortality and significant morbidity in the short and long term. Pregnant women with pre-existing diabetes are at greater risk of perinatal morbidity and diabetic complications. The relationship between glycaemic control and health outcomes for both mothers and infants indicates the potential for preconception care for these women to be of benefit. Objectives To assess the effects of preconception care in women with pre-existing diabetes on health outcomes for mother and baby. Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register was searched (30 April 2010) and reference lists of retrieved articles. Selection criteria Randomised, quasi-randomised and cluster-randomised trials evaluating preconception care of diabetic women. Data collection and analysis Two review authors independently conducted data extraction and quality assessment. We resolved disagreements through discussion or through a third author. Main results We included one trial (involving 53 women) in this review. The trial did not report on the prespecified outcomes of this review. Authors' conclusions Little evidence is available to recommend for or against preconception care for women with pre-existing diabetes. Further large, high-quality randomised controlled trials are needed to evaluate the effect of different protocols of preconception care for women with pre-existing diabetes.Joanna Tieu, Philippa Middleton and Caroline A Crowthe
Screening for gestational diabetes mellitus for improving maternal and infant health
No full textCopyright© 2008 John Wiley & Sons, Inc. All rights reserved.Joanna Tieu, Caroline A Crowther, Philippa Middleton and Andrew J McPhe
Screening and subsequent management for gestational diabetes for improving maternal and infant health
No full textEditorial group: Cochrane Pregnancy and Childbirth Group. Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 2, 2014. Review content assessed as up-to-date: 1 December 2013.Background: Gestational diabetes mellitus (GDM) is a form of diabetes that occurs in pregnancy. Although GDM usually resolves following birth, it is associated with significant morbidities for mother and baby both perinatally and in the long term. There is strong evidence to support treatment for GDM. However, there is little consensus on whether or not screening for GDM will improve maternal and infant health and if so, the most appropriate protocol to follow. Objectives: To assess the effects of different methods of screening for GDM and maternal and infant outcomes. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 December 2013). Selection criteria: Randomised and quasi-randomised trials evaluating the effects of different methods of screening for GDM. Data collection and analysis: Two review authors independently conducted data extraction and quality assessment. We resolved disagreements through discussion or through a third author. Main results: We included four trials involving 3972 women in the review. One quasi-randomised trial compared risk factor screening with universal or routine screening by 50 g oral glucose challenge testing. Women in the universal screening group were more likely to be diagnosed with GDM (one trial, 3152 women, risk ratio (RR) 0.44, 95% confidence interval (CI) 0.26 to 0.75). This trial did not report on the other primary outcomes of the review (positive screen for GDM, mode of birth, large-for-gestational age, or macrosomia). Considering secondary outcomes, infants of mothers in the risk factor screening group were born marginally earlier than infants of mothers in the routine screening group (one trial, 3152 women, mean difference (MD) -0.15 weeks, 95% CI -0.27 to -0.03). The remaining three trials evaluated different methods of administering a 50 g glucose load. Two small trials compared glucose monomer with glucose polymer testing, with one of these trials including a candy bar group. One trial compared a glucose solution with food. No differences in diagnosis of GDM were found between each comparison. However, in one trial significantly more women in the glucose monomer group screened positive for GDM than women in the candy bar group (80 women, RR 3.49, 95% CI 1.05 to 11.57). The three trials did not report on the primary review outcomes of mode of birth, large-for-gestational age or macrosomia. Overall, women drinking the glucose monomer experienced fewer side effects from testing than women drinking the glucose polymer (two trials, 151 women, RR 2.80, 95% CI 1.10 to 7.13). However, we observed substantial heterogeneity between the trials for this result (I² = 61%). Authors' conclusions: There was insufficient evidence to determine if screening for gestational diabetes, or what types of screening, can improve maternal and infant health outcomes.Joanna Tieu, Andrew J McPhee, Caroline A Crowther, Philippa Middleto
Preconception care for diabetic women to improve maternal and infant health
No full textJoanna Tieu, Philippa Middleton and Caroline A Crowthe
Interconception care for women with a history of gestational diabetes for improving maternal and infant outcomes
No full textBACKGROUND Gestational diabetes mellitus (GDM) is associated with adverse health outcomes for both mother and infant both perinatally and long-term. Women with a history of GDM are at risk of recurrence in subsequent pregnancies and may benefit from intervention in the interconception period to improve maternal and infant health outcomes. OBJECTIVES To investigate the effects of interconception care for women with a history of GDM on maternal and infant health outcomes. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2013). SELECTION CRITERIA Randomised controlled trials, including quasi-randomised controlled trials and cluster-randomised trials evaluating any protocol of interconception care with standard care or other forms of interconception care for women with a history of GDM in a previous pregnancy on maternal and infant health outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility. In future updates of this review, at least two review authors will extract data and assess the risk of bias of included studies. MAIN RESULTS One ongoing trial was identified. No eligible completed trials were identified. AUTHORS' CONCLUSIONS The role of interconception care for women with a history of gestational diabetes remains unclear. Randomised controlled trials are required evaluating different forms and protocols of interconception care for these women on perinatal and long-term maternal and infant health outcomes, acceptability of such interventions and cost-effectiveness.Joanna Tieu, Emily Bain, Philippa Middleton, Caroline A Crowthe
Screening and subsequent management for gestational diabetes for improving maternal and infant health
No full textBackgroundGestational diabetes mellitus (GDM) is a form of diabetes that occurs in pregnancy. Although GDM usually resolves following birth, it is associated with significant morbidities for mother and baby both perinatally and in the long term. There is strong evidence to support treatment for GDM. However, there is little consensus on whether or not screening for GDM will improve maternal and infant health and if so, the most appropriate protocol to follow.ObjectivesTo assess the effects of different methods of screening for gestational diabetes mellitus and maternal and infant outcomes.Search strategyWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2010).Selection criteriaRandomised and quasi-randomised trials evaluating the effects of different methods of screening for gestational diabetes mellitus.Data collection and analysisTwo review authors independently conducted data extraction and quality assessment. We resolved disagreements through discussion or through a third author.Main resultsWe included four trials involving 3972 women were included in the review. One quasi-randomised trial compared risk factor screening with universal or routine screening by 50 g oral glucose challenge testing. Women in the universal screening group were more likely to be diagnosed with GDM (one trial, 3152 women, risk ratio (RR) 0.44 95% confidence interval (CI) 0.26 to 0.75). Infants of mothers in the risk factor screening group were born marginally earlier than infants of mothers in the routine screening group (one trial, 3152 women, mean difference -0.15 weeks, 95% CI -0.27 to -0.53).The remaining three trials evaluated different methods of administering a 50 g glucose load. Two small trials compared glucose monomer with glucose polymer testing, with one of these trials including a candy bar group. One trial compared a glucose solution with food. No differences in diagnosis of GDM were found between each comparison. Overall, women drinking the glucose monomer experienced fewer side effects from testing than women drinking the glucose polymer (two trials, 151 women, RR 2.80, 95% CI 1.10 to 7.13). However, we observed high heterogeneity between the trials for this result (I(2) = 61%).Authors' conclusionsThere was insufficient evidence to determine if screening for gestational diabetes, or what types of screening, can improve maternal and infant health outcomes.Joanna Tieu, Philippa Middleton, Andrew J McPhee and Caroline A Crowthe
Dietary advice in pregnancy for preventing gestational diabetes mellitus (Protocol)
No full textPublished in Cochrane Database of Systematic Reviews, Issue 2, 2008 at www.interscience.wiley.comDiabetes mellitus is associated with abnormal glucose metabolism, with raised blood sugar and sugar in the urine. When this arises in pregnancy and disappears after birth, it is called 'gestational diabetes mellitus' or GDM. Between 1% and 14% of women develop GDM in pregnancy, with some women more at risk than others, and the severity can vary too. Risk factors for gestational glucose intolerance include being of a particular ethnicity, previous GDM, family history of type II diabetes mellitus and being older. Often there are no symptoms, or the symptoms can include tiredness, excessive thirst, passing a lot of urine and blurred vision. GDM can also cause significant problems such as a very large baby, an increased risk of the shoulder getting stuck during birth and injury to the mother during birth. There is also an increased chance of having an induced birth and caesarean birth. Babies can also often be born too early and have less chance of surviving, have problems with breathing and jaundice. In addition, there can be long-term effects such as increasing the risk of diabetes for mother and child later in life. Diet may play a significant part in the control of diabetes, with wholegrain carbohydrates and low glycaemic index diets (LGI) being helpful. LGI diets aim to slow down the digestion of food, allowing the body to better adjust to the load of sugar coming in after a meal. It is possible, therefore, that dietary advice in pregnancy may reduce the number of women who get GDM and its effects. The review of dietary advice in pregnancy to reduce GDM identified three trials involving 107 women, undertaken in Western countries. One trial involving 25 women looked at high-fibre diets compared with normal pregnancy diets. Two trials, involving 82 women, looked at LGI diet compared with high glycaemic index diet, with one of these trials also including an exercise component. The outcomes relevant to the review in the trial on high-fibre diets were inconclusive. The results on the low glycaemic index diet suggested that this may be beneficial to the mother and child. However, the evidence was not strong enough to be confident of these effects.Joanna Tieu, Caroline A Crowther and Philippa Middleto
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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