Design and methodology of a cluster-randomized trial in early care and education centers to meet physical activity guidelines: Sustainability via Active Garden Education (SAGE)

Strategies are needed to help early care and education centers (ECEC) comply with policies to meet daily physical activity and fruit and vegetable guidelines for young children. This manuscript describes the design and methodology of Sustainability via Active Garden Education (SAGE), a 12-session cluster-randomized controlled crossover design trial using community-based participatory research (CBPR) to test a garden-based ECEC physical activity and fruit and vegetables promotion intervention for young children aged 3–5 years in 20 sites. The SAGE curriculum uses the plant lifecycle as a metaphor for human development. Children learn how to plant, water, weed, harvest, and do simple food preparation involving washing, cleaning, and sampling fruit and vegetables along with active learning songs, games, science experiments, mindful eating exercises, and interactive discussions to reinforce various healthy lifestyle topics. Parents will receive newsletters and text messages linked to the curriculum, describing local resources and events, and to remind them about activities and assessments. Children will be measured on physical activity, height, and weight and observed during meal and snack times to document dietary habits. Parents will complete measures about dietary habits outside of the ECEC, parenting practices, home physical activity resources, and home fruit and vegetable availability. SAGE fills an important void in the policy literature by employing a participatory strategy to produce a carefully crafted and engaging curriculum with the goal of meeting health policy guidelines and educational accreditation standards. If successful, SAGE may inform and inspire widespread dissemination and implementation to reduce health disparities and improve health equity

Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): a double-blind, randomised controlled trial

Background Third-generation aromatase inhibitors are more effective than tamoxifen for preventing recurrence in postmenopausal women with hormone-receptor-positive invasive breast cancer. However, it is not known whether anastrozole is more effective than tamoxifen for women with hormone-receptor-positive ductal carcinoma in situ (DCIS). Here, we compare the efficacy of anastrozole with that of tamoxifen in postmenopausal women with hormone-receptor-positive DCIS. Methods In a double-blind, multicentre, randomised placebo-controlled trial, we recruited women who had been diagnosed with locally excised, hormone-receptor-positive DCIS. Eligible women were randomly assigned in a 1:1 ratio by central computer allocation to receive 1 mg oral anastrozole or 20 mg oral tamoxifen every day for 5 years. Randomisation was stratified by major centre or hub and was done in blocks (six, eight, or ten). All trial personnel, participants, and clinicians were masked to treatment allocation and only the trial statistician had access to treatment allocation. The primary endpoint was all recurrence, including recurrent DCIS and new contralateral tumours. All analyses were done on a modified intention-to-treat basis (in all women who were randomised and did not revoke consent for their data to be included) and proportional hazard models were used to compute hazard ratios and corresponding confidence intervals. This trial is registered at the ISRCTN registry, number ISRCTN37546358. Results Between March 3, 2003, and Feb 8, 2012, we enrolled 2980 postmenopausal women from 236 centres in 14 countries and randomly assigned them to receive anastrozole (1449 analysed) or tamoxifen (1489 analysed). Median follow-up was 7·2 years (IQR 5·6–8·9), and 144 breast cancer recurrences were recorded. We noted no statistically significant difference in overall recurrence (67 recurrences for anastrozole vs 77 for tamoxifen; HR 0·89 [95% CI 0·64–1·23]). The non-inferiority of anastrozole was established (upper 95% CI <1·25), but its superiority to tamoxifen was not (p=0·49). A total of 69 deaths were recorded (33 for anastrozole vs 36 for tamoxifen; HR 0·93 [95% CI 0·58–1·50], p=0·78), and no specific cause was more common in one group than the other. The number of women reporting any adverse event was similar between anastrozole (1323 women, 91%) and tamoxifen (1379 women, 93%); the side-effect profiles of the two drugs differed, with more fractures, musculoskeletal events, hypercholesterolaemia, and strokes with anastrozole and more muscle spasm, gynaecological cancers and symptoms, vasomotor symptoms, and deep vein thromboses with tamoxifen. Conclusions No clear efficacy differences were seen between the two treatments. Anastrozole offers another treatment option for postmenopausal women with hormone-receptor-positive DCIS, which may be be more appropriate for some women with contraindications for tamoxifen. Longer follow-up will be necessary to fully evaluate treatment differences

“Projeto conceitual de uma planta industrial de geração de eletricidade a partir de cdr (1mwe)”

O objetivo deste trabalho é propor e pré-dimensionar uma usina de geração elétrica a partir de Combustível Derivado de Resíduo (CDR) para uma capacidade de 1 MWe, utilizando como ponto de partida os dados obtidos de uma planta piloto de produção de CDR com uma capacidade nominal de 500 kg/h e os resultados de testes experimentais de gaseificação que foram realizados no laboratório do NEST da Universidade Federal de Itajubá utilizando o ar como agente de gaseificação. Os resultados experimentais foram de grande utilidade para inferir e determinar as condições operacionais da planta que foi projetada. Tendo como finalidade determinar o desempenho do processo foram usadas informações de modelos matemáticos elaborados em trabalhos anteriores. Foi usada um modelo em CFD como ferramenta para projetar os reatores usados na usina de 1MWe, analisando o processo em função da Razão de Equivalência (RE) na faixa de 0,25 até 0,45 e sua relação na composição do gás de síntese (CO, CH4 e H2) junto com o poder calorifico inferior do gás (PCIg). Foram analisados três cenários econômicos possível para determinar a viabilidade econômica do projeto da planta, variando a preço de venda da eletricidade (0,18 até 0,31 $R/kWh), variando as taxas contratuais para a disposição do RSU de acordo ao tamanho do município e variando a taxa de juros na faixa de 5$ 19.248.536) com uma TIR de 23,67% isto devido a que taxa para sua disposição é maior comparada com outros casos estudados

Make Haste, not Waste: Automated System Testing&amp;quot;, Extreme Programming and Agile Methods - XP Agile Universe 2003

Abstract. Haste (High-level Automated System Test Environment) represents an approach to system testing that is philosophically consistent with standard XP unit testing practices. Test code runs in the same address space as the application under test, allowing for ready examination of application state. The fundamental Haste abstractions of Story, Step, and StoryBook provide a framework to implement system tests. Utility classes simplify test development. In addition to acting as XP acceptance tests, Haste tests aid source maintenance and extension, and can play an important role in a release process. This paper describes the elements of Haste, our experience with using it to test a complex Java Swing application, and the perspective of the client for whom the application was developed. Haste is available under an open source license. Keywords. System, acceptance, automation, GUI, testing, Haste. 1 System Testing System tests validate the soundness and behavior of the application from the user’s perspective [1]. In an XP project, system tests serve as acceptance tests. In this rol

Presenter First: Organizing Complex GUI Applications for Test-Driven Development

Presenter First (PF) is a technique for organizing source code and development activities to produce fully tested GUI applications from customer stories using test-driven development. The three elements of Presenter First are a strategy for how applications are developed and tested, a variant on the Model View Presenter (MVP) design pattern, and a particular means of composing MVP triads. Presenter tests provide an economical alternative to automated GUI system tests. We have used Presenter First on projects ranging in size from several to a hundred MVP triads. This paper describes MVP creation, composition, scaling, and the tools and process we use. An example C # application illustrate

Design and methodology of a cluster-randomized trial in early care and education centers to meet physical activity guidelines: Sustainability via Active Garden Education (SAGE)

Strategies are needed to help early care and education centers (ECEC) comply with policies to meet daily physical activity and fruit and vegetable guidelines for young children. This manuscript describes the design and methodology of Sustainability via Active Garden Education (SAGE), a 12-session cluster-randomized controlled crossover design trial using community-based participatory research (CBPR) to test a garden-based ECEC physical activity and fruit and vegetables promotion intervention for young children aged 3–5 years in 20 sites. The SAGE curriculum uses the plant lifecycle as a metaphor for human development. Children learn how to plant, water, weed, harvest, and do simple food preparation involving washing, cleaning, and sampling fruit and vegetables along with active learning songs, games, science experiments, mindful eating exercises, and interactive discussions to reinforce various healthy lifestyle topics. Parents will receive newsletters and text messages linked to the curriculum, describing local resources and events, and to remind them about activities and assessments. Children will be measured on physical activity, height, and weight and observed during meal and snack times to document dietary habits. Parents will complete measures about dietary habits outside of the ECEC, parenting practices, home physical activity resources, and home fruit and vegetable availability. SAGE fills an important void in the policy literature by employing a participatory strategy to produce a carefully crafted and engaging curriculum with the goal of meeting health policy guidelines and educational accreditation standards. If successful, SAGE may inform and inspire widespread dissemination and implementation to reduce health disparities and improve health equity

Trends in Substance Use Prevention Program Participation Among Adolescents in the U.S

The aim of the article was to examine national trends in adolescent participation in substance use prevention programs (SUPP). We examine 15 years of cross-sectional data (2002–2016) from the National Survey on Drug Use and Health. Main outcomes were participation in past-year school and community-based SUPP (no/yes). Logistic regression was used to examine trends in the prevalence of participation. Participation in school-based SUPP decreased significantly from 48% among adolescents in 2002–2003 to 40% in 2015–2016, a 16.5% proportional decline. Significant declines for school-based participation were observed in all demographic and drug involvement subgroups examined. Youth participation in community-based SUPP also decreased significantly. However, this downward trend was significant only among younger teens, females, youth in very low (<$20,000) and moderate ($40,000–$74,999) income households and in rural areas. Participation in SUPP has decreased since the early 2000s, with noteworthy declines among Latino youth and youth from rural areas and socioeconomically disadvantaged backgrounds

Disconcerting levels of alcohol use among Venezuelan immigrant adolescents in the United States

•Despite risk, no prior research has studied drinking among Venezuelan migrant youth.•We address this gap via a sample of 373 recently-arrived Venezuelan youth in the US.•Half (52%) of Venezuelan migrants ages 12–17 report having initiated alcohol use.•This rate is 2.5 times greater than the overall rate for immigrant youth in the US (19%).•Venezuelan migrants are drinking at higher rates than their Hispanic/migrant peers. It is estimated that more than 4 million Venezuelans have left their country as a direct result of their nation’s widespread social and economic challenges. Although recent research identifies Venezuela as one of the nations with the highest rates of harmful alcohol consumption in the Americas, no research has been conducted on alcohol use among Venezuelan youth in diaspora. Data was collected between November 2018 and June 2019 from 373 Venezuelan immigrant youth ages 12–17 in the United States. The prevalence of past-month and lifetime alcohol use among Venezuelan youth is compared to that of other Hispanic and immigrant youth from the National Survey on Drug Use and Health (NSDUH), and the Construyendo Oportunidades Para Adolecentes Latinos (COPAL) study using independent sample t tests. The prevalence of past-month and lifetime alcohol use was significantly higher among Venezuelan immigrant youth (15% and 52%, respectively) compared to other Hispanic (9% and 28%) and immigrant (4.5% and 28%) youth in the NSDUH, and youth ages 14–17 in the COPAL study (4.0% and 22%). Among Venezuelan youth reporting alcohol use initiation, 1.5% of youth ages 12–14 and 19% ages 15–17 report lifetime alcohol intoxication. Although preliminary, results indicate that a disconcerting proportion of Venezuelan crisis migrant youth in the US report lifetime alcohol initiation and past-month use. These findings suggest the importance of future research to examine the prevalence and correlates of alcohol use in this population using recruitment and sampling methods that will allow for population-level estimates