A method is presented for long-term monitoring of vital signs tested during physical exercise. The system is based on reflective photoplethysmography (PPG), whose main component is a micro-optoelectronic sensor. The sensor is sealed within a biocompatible otoplastic housing so that it can be placed in the external auditory canal. The electronic device has a Bluetooth connection which enables to record/visualize the PPG signal on a personal computer or SmartPhone. This technology was tested indoors with a subject running on a treadmill at different speeds. The PPG signal was recorded together with an ECG used as a reference, and with an accelerometer to monitor and record motor activity. Theaccelerometer data were later used to reduce motion artifacts in the PPG signal. The results show that the system has potential to monitor cardiac activity at moderate speed (up to 4 km/h), but with increasing speed (i.e. running) the motion artifacts dominate the PPG. Therefore, additional studies on signal processing are needed to actively reduce motion artifacts, including the accelerometer data.
The present investigation aimed to describe how public policies implemented in Ecuador have benefited children from 0 to 5 years old, understood as early childhood in the Andean country. From a quantitative perspective, for the achievement of this objective, one of the main methods was the Documentary Bibliography, and the techniques of the documentary bibliographic review and the Survey; the first allowed the identification of the main concepts of public policies and integral child development, as well as the acceptance and practical interpretation that this topic of the international agenda has generated in Ecuador. The empirical study allowed to know the appreciation of the specialists of the Good Living Children's Centers, created by the State to strengthen the care of children by preserving their rights. After the discussion established between the theoretical foundation andpractice, it is concluded that, although there are public policies that have favored the integral development of children, with a marked impact on the family and on their knowledge on issues such as equity, inclusion and equality of opportunities, there are still limitations especially of the didactic means that benefit the activities developed in those facilities. Hence, a more rigorous methodological study on the subject is recommended and a call is made to government institutions to spare no material and human resources that continue to promote the quality of life of early childhood. ; En la presente investigación se propuso describir cómo las políticas públicas implementadas en Ecuador han beneficiado a los niños de 0 a 5 años, entendida como la primera infancia en el país andino. Desde una perspectiva cuantitativa, para el logro de este objetivo se utilizó como uno de los principales métodos el Bibliográfico Documental, y las técnicas de la revisión bibliográfica documental y la Encuesta; la primera posibilitó la identificación de los principales conceptos de políticas públicas y desarrollo infantil integral, así como la acepción e interpretación práctica que ha generado en Ecuador este tema de la agenda internacional. El estudio empírico permitió conocer la apreciación al respecto de los especialistas de los Centros Infantiles del Buen Vivir, creados por el Estado para fortalecer el cuidado de los niños preservando sus derechos. Luego de la discusión establecida entre la fundamentación teórica y la práctica, se concluye que, si bien se dispone de políticas públicas que han favorecido el desarrollo integral de los niños, con una marcada incidencia en la familia y sobre su conocimiento en temas como equidad, inclusión e igualdad de oportunidades, aún existen limitaciones sobre todo de los medios didácticos que beneficien las actividades desarrolladas en esas instalaciones. De ahí que se recomiende un estudio metodológico más riguroso sobre el asunto y se haga un llamado a las instituciones gubernamentales para no escatimar en recursos materiales y humanos que sigan promoviendo la calidad de vida de la primera infancia.
The present investigation aimed to describe how public policies implemented in Ecuador have benefited children from 0 to 5 years old, understood as early childhood in the Andean country. From a quantitative perspective, for the achievement of this objective, one of the main methods was the Documentary Bibliography, and the techniques of the documentary bibliographic review and the Survey; the first allowed the identification of the main concepts of public policies and integral child development, as well as the acceptance and practical interpretation that this topic of the international agenda has generated in Ecuador. The empirical study allowed to know the appreciation of the specialists of the Good Living Children's Centers, created by the State to strengthen the care of children by preserving their rights. After the discussion established between the theoretical foundation and practice, it is concluded that, although there are public policies that have favored the integral development of children, with a marked impact on the family and on their knowledge on issues such as equity, inclusion and equality of opportunities, there are still limitations especially of the didactic means that benefit the activities developed in those facilities. Hence, a more rigorous methodological study on the subject is recommended and a call is made to government institutions to spare no material and human resources that continue to promote the quality of life of early childhood. ; En la presente investigación se propuso describir cómo las políticas públicas implementadas en Ecuador han beneficiado a los niños de 0 a 5 años, entendida como la primera infancia en el país andino. Desde una perspectiva cuantitativa, para el logro de este objetivo se utilizó como uno de los principales métodos el Bibliográfico Documental, y las técnicas de la revisión bibliográfica documental y la Encuesta; la primera posibilitó la identificación de los principales conceptos de políticas públicas y desarrollo infantil integral, así como la acepción e interpretación práctica que ha generado en Ecuador este tema de la agenda internacional. El estudio empírico permitió conocer la apreciación al respecto de los especialistas de los Centros Infantiles del Buen Vivir, creados por el Estado para fortalecer el cuidado de los niños preservando sus derechos. Luego de la discusión establecida entre la fundamentación teórica y la práctica, se concluye que, si bien se dispone de políticas públicas que han favorecido el desarrollo integral de los niños, con una marcada incidencia en la familia y sobre su conocimiento en temas como equidad, inclusión e igualdad de oportunidades, aún existen limitaciones sobre todo de los medios didácticos que beneficien las actividades desarrolladas en esas instalaciones. De ahí que se recomiende un estudio metodológico más riguroso sobre el asunto y se haga un llamado a las instituciones gubernamentales para no escatimar en recursos materiales y humanos que sigan promoviendo la calidad de vida de la primera infancia.
The present investigation aimed to describe how public policies implemented in Ecuador have benefited children from 0 to 5 years old, understood as early childhood in the Andean country. From a quantitative perspective, for the achievement of this objective, one of the main methods was the Documentary Bibliography, and the techniques of the documentary bibliographic review and the Survey; the first allowed the identification of the main concepts of public policies and integral child development, as well as the acceptance and practical interpretation that this topic of the international agenda has generated in Ecuador. The empirical study allowed to know the appreciation of the specialists of the Good Living Children's Centers, created by the State to strengthen the care of children by preserving their rights. After the discussion established between the theoretical foundation and practice, it is concluded that, although there are public policies that have favored the integral development of children, with a marked impact on the family and on their knowledge on issues such as equity, inclusion and equality of opportunities, there are still limitations especially of the didactic means that benefit the activities developed in those facilities. Hence, a more rigorous methodological study on the subject is recommended and a call is made to government institutions to spare no material and human resources that continue to promote the quality of life of early childhood. ; En la presente investigación se propuso describir cómo las políticas públicas implementadas en Ecuador han beneficiado a los niños de 0 a 5 años, entendida como la primera infancia en el país andino. Desde una perspectiva cuantitativa, para el logro de este objetivo se utilizó como uno de los principales métodos el Bibliográfico Documental, y las técnicas de la revisión bibliográfica documental y la Encuesta; la primera posibilitó la identificación de los principales conceptos de políticas públicas y desarrollo infantil integral, así como la acepción e ...
The exposome represents the totality of life course environmental exposures (including lifestyle and other non-genetic factors), from the prenatal period onwards. This holistic concept of exposure provides a new framework to advance the understanding of complex and multifactorial diseases. Prospective pregnancy and birth cohort studies provide a unique opportunity for exposome research as they are able to capture, from prenatal life onwards, both the external (including lifestyle, chemical, social and wider community-level exposures) and the internal (including inflammation, metabolism, epigenetics, and gut microbiota) domains of the exposome. In this paper, we describe the steps required for applying an exposome approach, describe the main strengths and limitations of different statistical approaches and discuss their challenges, with the aim to provide guidance for methodological choices in the analysis of exposome data in birth cohort studies. An exposome approach implies selecting, pre-processing, describing and analyzing a large set of exposures. Several statistical methods are currently available to assess exposome-health associations, which differ in terms of research question that can be answered, of balance between sensitivity and false discovery proportion, and between computational complexity and simplicity (parsimony). Assessing the association between many exposures and health still raises many exposure assessment issues and statistical challenges. The exposome favors a holistic approach of environmental influences on health, which is likely to allow a more complete understanding of disease etiology. ; This work was supported by the European Union's Horizon 2020 research and innovation programme under Grant Agreement 733206 (LifeCycle Project) and 874583 (ATHLETE Project).
Background: Gestational diabetes and gestational hypertensive disorders are associated with offspring obesity, but the role of maternal adiposity in these associations remains unclear. We aimed to investigate whether these pregnancy complications affect the odds of offspring obesity independently of maternal obesity. Methods: We did an individual participant data (IPD) meta-analysis of mother–offspring pairs from prospective birth cohort studies that had IPD on mothers with singleton liveborn children born from 1989 onwards and had information available about maternal gestational diabetes, gestational hypertension or pre-eclampsia, and childhood body-mass index (BMI). We applied multilevel mixed-effects models to assess associations of gestational diabetes, gestational hypertension, and pre-eclampsia with BMI SD scores and the odds of overweight and obesity throughout childhood, adjusting for lifestyle characteristics (offspring's sex, maternal age, educational level, ethnicity, parity, and smoking during pregnancy). We then explored the extent to which any association was explained by maternal pre-pregnancy or early-pregnancy BMI. Findings: 160 757 mother–offspring pairs from 34 European or North American cohorts were analysed. Compared with uncomplicated pregnancies, gestational diabetes was associated with increased odds of overweight or obesity throughout childhood (odds ratio [OR] 1·59 [95% CI 1·36 to 1·86] for early childhood [age 2·0–4·9 years], 1·41 [1·26 to 1·57] for mid childhood [5·0–9·9 years], and 1·32 [0·97 to 1·78] for late childhood [10·0–17·9 years]); however, these associations attenuated towards the null following adjustment for maternal BMI (OR 1·35 [95% CI 1·15 to 1·58] for early childhood, 1·12 [1·00 to 1·25] for mid childhood, and 0·96 [0·71 to 1·31] for late childhood). Likewise, gestational hypertension was associated with increased odds of overweight throughout childhood (OR 1·19 [95% CI 1·01 to 1·39] for early childhood, 1·23 [1·15 to 1·32] for mid childhood, and 1·49 [1·30 to 1·70] for late childhood), but additional adjustment for maternal BMI largely explained these associations (1·01 [95% CI 0·86 to 1·19] for early childhood, 1·02 [0·95 to 1·10] for mid childhood, and 1·18 [1·03 to 1·36] for late childhood). Pre-eclampsia was associated with decreased BMI in early childhood only (difference in BMI SD score −0·05 SD score [95% CI −0·09 to −0·01]), and this association strengthened following additional adjustment for maternal BMI. Interpretation: Although lowering maternal risk of gestational diabetes, gestational hypertension, and pre-eclampsia is important in relation to maternal and fetal pregnancy outcomes, such interventions are unlikely to have a direct impact on childhood obesity. Preventive strategies for reducing childhood obesity should focus on maternal BMI rather than on pregnancy complications. Funding: EU's Horizon 2020 research and innovation programme (LifeCycle Project). ; This study has received support from the US National Institute of Health (R01 DK10324) and European Research Council under the European Union's Seventh 22 Framework Programme (FP7/2007-2013) / ERC grant agreement no 669545. The Swedish Research Council, The Swedish Heart and Lung Foundation, The Swedish Research Council for Working Life and Social Welfare, the Swedish Asthma and Allergy Association Research Foundation, The Swedish Research Council Formas, Stockholm County Council, and the European Commission's Seventh Framework 29 Program MeDALL under grant agreement No. 261357. This study has received support from the British Heart Foundation (CS/16/4/32482), US National Institute of Health (R01 DK10324) and European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013) / ERC grant agreement no 669545. The general design of the Generation R Study is made possible by financial support from the Erasmus MC, University Medical Center, Rotterdam, Erasmus University Rotterdam, Netherlands Organization for Health Research and Development (ZonMw), Netherlands Organisation for Scientific Research (NWO), Ministry of Health, Welfare and Sport and Ministry of Youth and Families. Research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007- 2013), project EarlyNutrition under grant agreement n°289346, the European Union's Horizon 2020 research and innovation programme under grant agreement No 633595 (DynaHEALTH) and the European Union's Horizon 2020 research and innovation programme under grant agreement 733206 (LifeCycle Project). European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreements Early Nutrition n° 289346 and by funds from the Norwegian Research Council's MILPAAHEL programme, project No.213148. This study was funded by Grants from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Spain: ISCIII (G03/176; FIS-FEDER: PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, and PI16/1288; Miguel Servet-FEDER CP11/00178, CP15/00025, and CPII16/00051), and Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, and UGP-15-249). The "Rhea" project was financially supported by European projects (EU FP6-2003-Food-3-NewGeneris, EU FP6. STREP Hiwate, EU FP7 ENV.2007.1.2.2.2. Project No 211250 Escape, EU FP7-2008-ENV-28.1.2.1.4 envirogenomarkers, EU FP7-HEALTH-2009- single stage CHICOS, EU FP7 ENV.2008.1.2.1.6. Proposal No 226285 ENRIECO, EU- FP7- HEALTH-2012 Proposal No 308333 HELIX) and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011-2014; "Rhea Plus": Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012-15). ROLO is supported by the Health Research Board Ireland, the Health Research Centre for Health and Diet Research, and the European Union's Seventh Framework Programme (FP7/2007-2013), project EarlyNutrition under grant agreement no. 289346. The SWS is supported by grants from the Medical Research Council, National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, and the European Union's Seventh Framework Programme (FP7/2007-2013), project EarlyNutrition (grant 289346). Study participants were drawn from a cohort study funded by the Medical Research Council and the Dunhill Medical Trust.
