RESUMO
BACKGROUND: Caesarean sections (CS) continue to increase worldwide. Multiple and complex factors are contributing to the increase, including non-clinical factors related to individual women, families and their interactions with health providers. This global qualitative evidence synthesis explores women's preferences for mode of birth and factors underlying preferences for CS. METHODS: Systematic database searches (MEDLINE, EMBASE, CINAHL, PsycINFO) were conducted in December 2016 and updated in May 2019 and February 2021. Studies conducted across all resource settings were eligible for inclusion, except those from China and Taiwan which have been reported in a companion publication. Phenomena of interest were opinions, views and perspectives of women regarding preferences for mode of birth, attributes of CS, societal and cultural beliefs about modes of birth, and right to choose mode of birth. Thematic synthesis of data was conducted. Confidence in findings was assessed using GRADE-CERQual. RESULTS: We included 52 studies, from 28 countries, encompassing the views and perspectives of pregnant women, non-pregnant women, women with previous CS, postpartum women, and women's partners. Most of the studies were conducted in high-income countries and published between 2011 and 2021. Factors underlying women preferences for CS had to do mainly with strong fear of pain and injuries to the mother and child during labour or birth (High confidence), uncertainty regarding vaginal birth (High confidence), and positive views or perceived advantages of CS (High confidence). Women who preferred CS expressed resoluteness about it, but there were also many women who had a clear preference for vaginal birth and those who even developed strategies to keep their birth plans in environments that were not supportive of vaginal births (High confidence). The findings also identified that social, cultural and personal factors as well as attributes related to health systems impact on the reasons underlying women preferences for various modes of birth (High confidence). CONCLUSIONS: A wide variety of factors underlie women's preferences for CS in the absence of medical indications. Major factors contributing to perceptions of CS as preferable include fear of pain, uncertainty with vaginal birth and positive views on CS. Interventions need to address these factors to reduce unnecessary CS.
Assuntos
Cesárea/psicologia , Preferência do Paciente/psicologia , Gestantes/psicologia , China , Gerenciamento de Dados/métodos , Família/psicologia , Feminino , Humanos , Trabalho de Parto/psicologia , Parto/psicologia , Período Pós-Parto/psicologia , Gravidez , Pesquisa Qualitativa , TaiwanRESUMO
Umbilical cord blood (UCB) is a suitable source for hematopoietic stem cell transplantation. The study of HLA genes by next generation sequencing is commonly used in transplants. Donor/patient HLA matching is often higher within groups of common ancestry, however "Hispanic" is a broad category that fails to represent Argentina's complex genetic admixture. Our aim is to describe HLA diversity of banked UCB units collected across the country taking into consideration donor's reported ancestral origins as well as geographic distribution. Our results showed an evenly distribution of units mainly for 2 groups: of European and of Native American descent, each associated to a defined geographic location pattern (Central vs. North regions). We observed differences in allele frequency distributions for some alleles previously described in Amerindian populations: for Class I (A*68:17, A*02:11:01G, A*02:22:01G, B*39:05:01, B*35:21, B*40:04, B*15:04:01G, B*35:04:01, B*51:13:01) and Class II (DRB1*04:11:01, DRB1*04:07:01G/03, DRB1*08:02:01, DRB1*08:07, DRB1*09:01:02G, DRB1*14:02:01, DRB1*16:02:01G). Our database expands the current knowledge of HLA diversity in Argentinian population. Although further studies are necessary to fully comprehend HLA heterogeneity, this report should prove useful to increase the possibility of finding compatible donors for successful allogeneic transplant and to improve recruitment strategies for UCB donors across the country.
Assuntos
Sangue Fetal/metabolismo , Frequência do Gene/genética , Antígenos de Histocompatibilidade Classe I/genética , Alelos , Armazenamento de Sangue/métodos , Gerenciamento de Dados/métodos , Haplótipos/genética , Transplante de Células-Tronco Hematopoéticas/métodos , Hispânico ou Latino/genética , Teste de Histocompatibilidade/métodos , Humanos , Doadores de TecidosRESUMO
Data on diagnosis of infection in the general population are strategic for different applications in the public and private spheres. Among them, the data related to symptoms and people displacement stand out, mainly considering highly contagious diseases. This data is sensitive and requires data privacy initiatives to enable its large-scale use. The search for population-monitoring strategies aims at social tracking, supporting the surveillance of contagions to respond to the confrontation with COVID-19. There are several data privacy issues in environments where IoT devices are used for monitoring hospital processes. In this research, we compare works related to the subject of privacy in the health area. To this end, this research proposes a taxonomy to support the requirements necessary to control patient data privacy in a hospital environment. According to the tests and comparisons made between the variables compared, the application obtained results that contribute to the scenarios applied. In this sense, we modeled and implemented an application. By the end, a mobile application was developed to analyze the privacy and security constraints with COVID-19.
Assuntos
Segurança Computacional , Confidencialidade , Gerenciamento de Dados/métodos , Algoritmos , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Humanos , Internet das Coisas , Aplicativos Móveis , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/virologia , SARS-CoV-2 , Telemedicina , Dispositivos Eletrônicos VestíveisRESUMO
Due to datasets have continuously grown, efforts have been performed in the attempt to solve the problem related to the large amount of unlabeled data in disproportion to the scarcity of labeled data. Another important issue is related to the trade-off between the difficulty in obtaining annotations provided by a specialist and the need for a significant amount of annotated data to obtain a robust classifier. In this context, active learning techniques jointly with semi-supervised learning are interesting. A smaller number of more informative samples previously selected (by the active learning strategy) and labeled by a specialist can propagate the labels to a set of unlabeled data (through the semi-supervised one). However, most of the literature works neglect the need for interactive response times that can be required by certain real applications. We propose a more effective and efficient active semi-supervised learning framework, including a new active learning method. An extensive experimental evaluation was performed in the biological context (using the ALL-AML, Escherichia coli and PlantLeaves II datasets), comparing our proposals with state-of-the-art literature works and different supervised (SVM, RF, OPF) and semi-supervised (YATSI-SVM, YATSI-RF and YATSI-OPF) classifiers. From the obtained results, we can observe the benefits of our framework, which allows the classifier to achieve higher accuracies more quickly with a reduced number of annotated samples. Moreover, the selection criterion adopted by our active learning method, based on diversity and uncertainty, enables the prioritization of the most informative boundary samples for the learning process. We obtained a gain of up to 20% against other learning techniques. The active semi-supervised learning approaches presented a better trade-off (accuracies and competitive and viable computational times) when compared with the active supervised learning ones.
Assuntos
Gerenciamento de Dados/métodos , Aprendizado de Máquina SupervisionadoRESUMO
OBJECTIVES: to report the user experience of the webQDA software in the support of qualitative data analysis about health literacy of older adults. METHODS: quasi-experimental research developed from January 2014 to January 2015, with 118 older adults, all of whom were interviewed to assess the level of health literacy. Interviews were carried out before and after four educational interventions, according to Freire's method named Culture Circle. The interviews were transcribed and entered in the software, which highlighted the analytical categories. RESULTS: the systems of sources, interpretative encoding and questioning of the data available in the software allowed the construction of three categories for the literacy levels and four categories for their dimensions. FINAL CONSIDERATIONS: We concluded that the webQDA software enables the structured encoding of qualitative materials, ensuring faster and effective management of data with systematization and analytical transparency.
Assuntos
Gerenciamento de Dados/instrumentação , Pesquisa em Enfermagem/métodos , Pesquisa Qualitativa , Pesquisadores/psicologia , Software/normas , Gerenciamento de Dados/métodos , Humanos , Acontecimentos que Mudam a Vida , Pesquisa em Enfermagem/tendências , Projetos de Pesquisa , Software/tendênciasRESUMO
OBJECTIVE: In this study, we present an application type software which employs the Nursing Activities Score (NAS), a management tool for measuring nursing workload prospectively. METHOD: The system was developed in two modules: WEB (controlled from an Internet browser) for data administration using Java Script; and APP (operated from a smartphone or tablet device) for data acquisition using Hypertext Preprocessor (PHP). White and black box tests were performed in the software. RESULTS: A software was developed with an interface that allows the calculation of the scale score by the same professional who provided assistance, generating reports to help nursing management. The functional test was successfully performed using the Android operational system. CONCLUSION: The efficiency of the software was demonstrated by the functional test and the main innovations brought herein are the prospective use and the generation of management reports, which can contribute positively by improving nursing quality and safety in the intensive care unit.
Assuntos
Gerenciamento de Dados/métodos , Unidades de Terapia Intensiva/organização & administração , Internet/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Smartphone/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Humanos , Estudos ProspectivosRESUMO
ABSTRACT Objectives: to report the user experience of the webQDA software in the support of qualitative data analysis about health literacy of older adults. Methods: quasi-experimental research developed from January 2014 to January 2015, with 118 older adults, all of whom were interviewed to assess the level of health literacy. Interviews were carried out before and after four educational interventions, according to Freire's method named Culture Circle. The interviews were transcribed and entered in the software, which highlighted the analytical categories. Results: the systems of sources, interpretative encoding and questioning of the data available in the software allowed the construction of three categories for the literacy levels and four categories for their dimensions. Final considerations: We concluded that the webQDA software enables the structured encoding of qualitative materials, ensuring faster and effective management of data with systematization and analytical transparency.
RESUMEN Objetivos: relatar la experiencia con la utilización del software webQDA como base al análisis de los datos cualitativos sobre literacidad en salud de ancianos. Métodos: investigación cuasiexperimental realizada en el período de enero de 2014 a enero de 2015, en la cual participaron 118 ancianos mediante entrevistas para evaluar el nivel de literacidad en salud. Se realizaron entrevistas antes y después de cuatro intervenciones educativas, de acuerdo con el método problematizador freireano titulado Círculo de Cultura. Se transcribieron las entrevistas y las insertaron en el software, lo que permitió obtener las categorías analíticas. Resultados: los sistemas de fuentes, de codificación interpretativa y de cuestionamiento de los datos disponibles en el software permitieron elaborar tres categorías sobre los niveles de literacidad y cuatro categorías sobre sus dimensiones. Consideraciones finales: Se concluyó que el software webQDA permite la codificación estructurada de los materiales cualitativos, lo que promueve una gestión más rápida y eficaz de los datos a partir de la sistematización y transparencia analítica.
RESUMO Objetivos: relatar a experiência de uso do software webQDA no apoio à análise dos dados qualitativos acerca do letramento em saúde de idosos. Métodos: pesquisa quase experimental desenvolvida no período de janeiro de 2014 a janeiro de 2015, com 118 idosos, os quais foram entrevistados para avaliar o nível de letramento em saúde. Foram realizadas entrevistas antes e após quatro intervenções educativas, segundo o método problematizador freireano denominado Círculo de Cultura. As entrevistas foram transcritas e inseridas no software, o que permitiu evidenciar as categorias analíticas. Resultados: os sistemas de fontes, codificação interpretativa e questionamento dos dados disponíveis no software permitiram a construção de três categorias para os níveis do letramento e de quatro categorias para as suas dimensões. Considerações finais: Conclui-se que o software webQDA permite a codificação estruturada dos materiais qualitativos, assegurando gestão mais rápida e eficaz dos dados a partir da sistematização e transparência analítica.
Assuntos
Humanos , Pesquisadores/psicologia , Software/normas , Pesquisa em Enfermagem/métodos , Pesquisa Qualitativa , Gerenciamento de Dados/instrumentação , Projetos de Pesquisa , Software/tendências , Pesquisa em Enfermagem/tendências , Gerenciamento de Dados/métodos , Acontecimentos que Mudam a VidaRESUMO
The Demographic and Family Health Survey (ENDES, in Spanish) is a national population-based survey with representation at the departmental level and area of residence, constituting a source of information on the health status of the Peruvian population. In order to standardize its processing and subsequent reuse by the academic community and other stakeholders, we documented the code for the manipulation, analysis, and visualization of data from the ENDES 2017 health questionnaire, through an example on the prevalence of hypertension and obesity, using the R statistical programming environment and language. The R code is presented and detailed sequentially, as well as the theoretical support of the survey structure for the manipulation of databases, considering that the complex structure of the ENDES could be a potential barrier faced by researchers. Finally, this example can serve as a basis for generating further studies based on the ENDES that are relevant to public health decision-making.
La Encuesta Demográfica de Salud Familiar (ENDES) es una encuesta nacional de base poblacional con representatividad a nivel departamental y área de residencia, constituyéndose en una fuente de información del estado de salud de la población peruana. Con el objetivo de estandarizar su procesamiento y posterior reutilización por parte de la comunidad académica y otros actores interesados; documentamos el código para la manipulación, análisis y visualización de datos del cuestionario de salud de la ENDES 2017, mediante un ejemplo sobre prevalencia de hipertensión arterial y obesidad, utilizando el entorno y lenguaje de programación estadístico R. Se presenta y detalla secuencialmente el código en R, así como, el sustento teórico de la estructura de la encuesta para la manipulación de las bases de datos, considerando que la compleja estructura de la ENDES podría ser una potencial barrera que enfrentan los investigadores. Finalmente, este ejemplo puede servir de base para que se generen mayores estudios basados en la ENDES que sean relevantes para la toma de decisiones en salud pública.
Assuntos
Análise de Dados , Gerenciamento de Dados/métodos , Visualização de Dados , Saúde da Família , Inquéritos Epidemiológicos , Sistemas de Gerenciamento de Base de Dados , HumanosRESUMO
En el proceso de revisión, se usaron las revisiones bibliográficas como fuentes para profundizar el debate sobre la ética. Las declaraciones, informes y documentos de orientación de fuentes autorizadas han cumplido una función prominente en estas deliberaciones, como el Código de Nüremberg (1947), la Declaración Universal de Derechos Humanos de las Naciones Unidas (1948), el Pacto Internacional de Derechos Civiles y Políticos de las Naciones Unidas (1966), el Informe Belmont (1979), la Norma sobre Buenas Prácticas Clínicas (BPC) de la Conferencia Internacional sobre Armonización de los Requisitos Técnicos aplicable al Registro de Sustancias Farmacéuticas para Uso Humano (ICH) (1996), la Convención de Oviedo del Consejo de Europa (1997), la Declaración Universal sobre Bioética y Derechos Humanos de la UNESCO (2005), las Consideraciones éticas en ensayos biomédicos de prevención de la infección por el VIH del ONUSIDA/OMS (2007/2012), las Pautas y orientación operativa para la revisión ética de la investigación en salud con seres humanos de la OMS (2011) y la Declaración de Helsinki de la Asociación Médica Mundial (2013). Algunas de estas pautas se han usado ampliamente, en particular el documento del ONUSIDA y la OMS (2012) para la pauta 7 relativa al involucramiento de la comunidad. Igualmente, los libros de texto, los marcos éticos existentes para la investigación con seres humanos y los informes sobre la investigación con seres humanos fueron fuentes valiosas de información. El grupo de trabajo revisó artículos publicados en las principales revistas de ética como (en orden alfabético): el American Journal of Bioethics, BMC Medical Ethics, el Cambridge Quarterly of Healthcare Ethics, Developing World Bioethics, el Hastings Center Report, el Journal of Bioethical Inquiry, el Journal of Empirical Research on Human Research Ethics, el Journal of Law, Medicine and Ethics, el Journal of Medical Ethics, el Journal of Medicine and Philosophy, Medicine, Health Care and Philosophy, así como otros artículos de las principales revistas médicas o científicas, como el BMJ, The Lancet, el New England Journal of Medicine y Science. Las revisiones bibliográficas se usaron de tres maneras. Primero, buscamos las principales pautas éticas sobre la investigación con seres humanos y libros de texto sobre la ética de investigación para detectar nuevos temas o puntos de vista en los debates existentes. Por ejemplo, muchas pautas han incluido pronunciamientos sobre los biobancos, que fue una de las razones para fusionar las pautas del CIOMS sobre la investigación epidemiológica con las de investigación biomédica. También realizamos búsquedas en Embase y MEDLINE sobre artículos de análisis y trabajos con posiciones fuertes ante ciertos temas. Por ejemplo, el análisis de componentes y la prueba de riesgo neto son dos enfoques recientes en las evaluaciones de riesgo-beneficio. No hay ningún acuerdo entre los bioéticos sobre cuál de estos enfoques es preferible. El grupo de trabajo leyó documentos pertinentes sobre estos enfoques y formuló un enfoque intermedio. Se adoptó un proceso similar para la vulnerabilidad. En publicaciones recientes ha surgido el consenso de que la vulnerabilidad ya no puede aplicarse a grupos enteros. Como resultado, el grupo de trabajo eliminó el enfoque de grupo. En su lugar, las pautas se centran en aquellas características que conducen a considerar vulnerables a ciertos grupos y en las protecciones específicas que se necesitan en esas situaciones. Tercero, se realizaron revisiones bibliográficas para abordar temas relativamente nuevos, como los procedimientos para solicitar de manera informada no ser incluido en relación con los biobancos o la información que se brinda a los participantes en una investigación sobre los hallazgos que hayan sido solicitados o no. El grupo de trabajo revisó documentos sobre estos temas y asumió una posición sobre ellos.