Using the Medical Research Council framework for the development and evaluation of complex interventions in a theory-based infant feeding intervention to prevent childhood obesity:The baby milk intervention and trial

Introduction. We describe our experience of using the Medical Research Council framework on complex interventions to guide the development and evaluation of an intervention to prevent obesity by modifying infant feeding behaviours. Methods. We reviewed the epidemiological evidence on early life risk factors for obesity and interventions to prevent obesity in this age group. The review suggested prevention of excess weight gain in bottle-fed babies and appropriate weaning as intervention targets; hence we undertook systematic reviews to further our understanding of these behaviours. We chose theory and behaviour change techniques that demonstrated evidence of effectiveness in altering dietary behaviours. We subsequently developed intervention materials and evaluation tools and conducted qualitative studies with mothers (intervention recipients) and healthcare professionals (intervention deliverers) to refine them. We developed a questionnaire to assess maternal attitudes and feeding practices to understand the mechanism of any intervention effects. Conclusions. In addition to informing development of our specific intervention and evaluation materials, use of the Medical Research Council framework has helped to build a generalisable evidence base for early life nutritional interventions. However, the process is resource intensive and prolonged, and this should be taken into account by public health research funders. This trial is registered with ISRTCN: 20814693 Baby Milk Trial

Ontology-Based Data Access to Big Data

Recent approaches to ontology-based data access (OBDA) have extended the focus from relational database systems to other types of backends such as cluster frameworks in order to cope with the four Vs associated with big data: volume, veracity, variety and velocity (stream processing). The abstraction that an ontology provides is a benefit from the enduser point of view, but it represents a challenge for developers because high-level queries must be transformed into queries executable on the backend level. In this paper, we discuss and evaluate an OBDA system that uses STARQL (Streaming and Temporal ontology Access with a Reasoning-based Query Language), as a high-level query language to access data stored in a SPARK cluster framework. The development of the STARQL-SPARK engine show that there is a need to provide a homogeneous interface to access both static and temporal as well as streaming data because cluster frameworks usually lack such an interface. The experimental evaluation shows that building a scalable OBDA system that runs with SPARK is more than plug-and-play as one needs to know quite well the data formats and the data organisation in the cluster framework

Using the Medical Research Council framework for the development and evaluation of complex interventions in a theory-based infant feeding intervention to prevent childhood obesity: The Baby Milk intervention and trial’

Introduction - We describe our experience of using the Medical Research Council framework on complex interventions to guide the development and evaluation of an intervention to prevent obesity by modifying infant feeding behaviours. Methods - We reviewed the epidemiological evidence on early life risk factors for obesity and interventions to prevent obesity in this age group. The review suggested prevention of excess weight gain in bottle-fed babies and appropriate weaning as intervention targets, hence we undertook systematic reviews to further our understanding of these behaviours. We chose theory and behaviour change techniques that demonstrated evidence of effectiveness in altering dietary behaviours. We subsequently developed intervention materials and evaluation tools and conducted qualitative studies with mothers (intervention recipients) and healthcare professionals (intervention deliverers) to refine these. We developed a questionnaire to assess maternal attitudes and feeding practices to understand the mechanism of any intervention effects. Conclusions - In addition to informing development of our specific intervention and evaluation materials, use of the Medical Research Council framework has helped to build a generalisable evidence base for early life nutritional interventions. However, the process is resource intensive and prolonged, and this should be taken into account by public health research funders.This work was supported by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The Baby Milk Trial is funded by the National Prevention Research Initiative (http://www.npri.org.uk Grant number MR/J000361/1). The Funding Partners relevant to this award are (in alphabetical order): Alzheimer's Research Trust; Alzheimer's Society; Biotechnology and Biological Sciences Research Council; British Heart Foundation; Cancer Research UK; Chief Scientist Office, Scottish Government Health Directorate; Department of Health; Diabetes UK; Economic and Social Research Council; Health and Social Care Research and Development Division of the Public Health Agency (HSC R&D Division); Medical Research Council; The Stroke Association; Wellcome Trust; Welsh Assembly Government; and World Cancer Research Fund. RL was funded by a MRC Population Health Fellowship (Grant number G070165).This is the final published version. It is also available from Hindawi at http://www.hindawi.com/journals/jobe/2014/646504/

Development of a questionnaire to assess maternal attitudes towards infant growth and milk feeding practices.

BACKGROUND: There is increasing recognition that public health strategies to prevent childhood obesity need to start early in life. Any behavioural interventions need to target maternal attitudes and infant feeding practices, This paper describes the development and preliminary validation of a questionnaire to assess maternal attitudes towards infant growth and milk feeding practices. METHODS: We designed a 57-item (19 questions), self-administered questionnaire to measure the following four domains- 1) type of milk feeding, decision making and sources of advice; 2) frequency and quantity of milk feeds; 3) attitudes to infant feeding and growth; and 4) theory-based beliefs about following infant feeding recommendations. Forty mothers completed the questionnaire on two occasions six days apart (to assess test-retest reliability) and then participated in a semi-structured, open-ended telephone interview covering the same domains (to assess criterion validity). Percentage agreement, Cohen's Kappas (for categorical variables) and Spearman's correlation coefficients (for continuous variables) were used to quantify reliability and validity. Internal consistency between theory-based constructs (self-efficacy, outcome expectancy and intention) was quantified by Chronbach's alpha. RESULTS: Of the 57 questionnaire items 51 (89%) had percentage agreement above 70% indicating good test-retest reliability, and the remaining 6 items had moderate or substantial levels of agreement (kappa 0.41-0.68). Comparing questionnaire with interview coding (validity), percentage agreement was above 66% for 39/57 items (68%). Of the 16 items with percentage agreement below 66%, only five had kappa values below 0.20 (two items had insufficient interview responses). Internal consistency was 0.51, 0.79 and 0.90 for self-efficacy, outcome expectancy and intention respectively. CONCLUSIONS: This questionnaire could be a useful tool in understanding the determinants of infant feeding and the 'causal mechanism' of interventions that target infant feeding practices to prevent early obesity.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Implementation of a Federated Information System by Means of Reuse of Research Data Archived in Research Data Repositories

At universities, research data is increasingly stored in research data repositories according to a data management plan (DMP) and thus made available for further use. The challenge of reusing hundreds, thousands, or millions of data sets is to obtain an overview of the data in a short period of time and to search through all the data. The high variability of the formats used to store research data requires a new approach to data reusability that focuses on the visualisation and searchability of archived research data, which can also be combined with each other. In this article, we present a practical DMP that describes how information systems can be created on demand by reusing research data archived in research data repositories and how these systems can be merged into a federated information system. As a result, in our projects, information systems have been created in minutes or a couple of hours with few resources. The initial effort to create a federated system remains; however, this allows federated searches to be performed. Extending a federated system to include other information systems can then be accomplished by making a few configurations and manageable adjustments to the source code

Randomised controlled trial of a theory-based behavioural intervention to reduce formula milk intake

Objective: To assess the efficacy of a theory-based behavioural intervention to prevent rapidweight gain in formula-milk fed infants.  Design: In this single (assessor) blind, randomised controlled trial, 669 healthy full-terminfants receiving formula-milk within 14 weeks of birth were individually-randomised tointervention (n=340) or attention-matched control (n=329) groups. The intervention aimed toreduce formula-milk intakes, and promote responsive feeding and growth monitoring toprevent rapid weight gain (>+ 0.67 standard deviation scores [SDS]). It was delivered tomothers by trained facilitators up to infant age 6 months through 3 face-to-face contacts, 2telephone contacts, and written materials.  Results: Retention was 93% (622) at 6 months, 88% (586) at 12 months, and 94% attended >4/5 sessions. The intervention strengthened maternal attitudes to following infant feedingrecommendations, reduced reported milk intakes at ages 3 (-14%; intervention vs controlinfants), 4 (-12%), 5 (-9%), and 6 (-7%) months, slowed initial infant weight gain frombaseline to 6 months (mean change 0.32 vs 0.42 SDS, baseline-adjusted difference(intervention vs control) -0.08 [95% CI; -0.17, -0.004] SDS), but had no effect on the primaryoutcome of weight gain to 12 months (baseline-adjusted difference -0.04 [-0.17, 0.10] SDS).By 12 months, 40.3% of infants in the intervention group and 45.9% in the control groupshowed rapid weight gain (OR: 0.84 [95% CI; 0.59, 1.17]).  Conclusions: Despite reducing milk intakes and initial weight gain, the intervention did notalter the high prevalence of rapid weight gain to age 12 months suggesting the need forsustained intervention

Atypical clinical presentation of mucopolysaccharidosis type II (Hunter syndrome): a case report

<p>Abstract</p> <p>Introduction</p> <p>We present a very rare case of mucopolysaccharidosis with atypical presentation such as mild mental retardation, an acrocephalic head and no corneal clouding. The purpose of presenting this case is to highlight the distinctive manifestation of mucopolysaccharidosis type II (Hunter syndrome).</p> <p>Case presentation</p> <p>A 10-year-old East Asian boy presented with abdominal distension of five years' duration and complained of shortness of breath on and off for the same period. On examination his head was large and his head circumference was 54.5 cm. His neck was short, he had coarse facial features, a depressed nasal bridge and small stubby fingers with flexion of distal interphalangeal joints, and a low arched palate was observed. There was mild mental retardation.</p> <p>Conclusion</p> <p>Based on clinical findings and radiological features it is possible to diagnose a case of mucopolysaccharidosis.</p> <p>Careful and systemic approach is needed to accurately diagnose the exact type as enzymatic studies are not available in most centers.</p