Estudio mediante redes neuronales de la incidencia de los infartos en la calidad de vida

Desde hace unas décadas ha venido produciéndose un incremento en la longevidad de la población debido en gran parte a los avances realizados en el campo médico, creando una nueva meta, alcanzar esa longevidad con la máxima calidad de vida posible. Por esta razón se encuentran ya gran cantidad de publicaciones, estudios e investigaciones en el ámbito de la calidad de vida, resolviendo cuestiones sobre cómo evaluarla, identificar qué factores se ve afectada y cómo mejorarla.En este estudio se ha pretendido realizar la búsqueda y análisis de las diferentes investigaciones que se han realizado a nivel internacional sobre calidad de vida pero añadiendo una herramienta novedosa a su comprensión, las redes neuronales. Además, se ha procesado mediante el uso de redes auto-organizadas una base de datos realizada junto al grupo de investigación de enfermería con el que se ha trabajado, compuesta de dos cuestionarios, uno de creación propia denominado “Temores, preocupaciones y afectación de la calidad de vida diaria de pacientes post infarto agudo de miocardio” y otro de calidad de vida conocido como EuroQoL 5D-3L. Como resultado principal obtenido de la fase de documentación destaca la escasez de investigaciones en España sobre el uso de redes neuronales para el estudio de la calidad de vida. En este ámbito, este proyecto ha pretendido ser pionero en el empleo de dichas técnicas consiguiendo el reconocimiento de ciertos patrones entre los temores y preocupaciones que sufren los pacientes post-infartados y la división de los posibles niveles de calidad de vida relacionada con la salud

The nurse, a key in the care of patients with irritable bowel syndrome

Trabajo fin de grado en EnfermeríaObjetivo: determinar el rol de la enfermera en el proceso asistencial de las personas con Síndrome de Intestino Irritable. Método: revisión narrativa a partir de los resultados obtenidos de la búsqueda bibliográfica en las bases de datos de Ciencias de la Salud: PubMed, CINHAL y Web Of Science. Resultados: se seleccionaron 20 artículos por ser los más idóneos para alcanzar los objetivos planteados en el trabajo. Se generaron dos categorías de análisis: barreras que dificultan el afrontamiento y el autocuidado en pacientes con Síndrome de Intestino Irritable e intervenciones enfermeras dirigidas a la mejora de su calidad de vida. Las personas con Síndrome de Intestino Irritable señalaron como principales limitaciones la naturaleza de la atención recibida y la escasez de información ofertada por los profesionales sobre la enfermedad. Los estudios coinciden en que las intervenciones deben estar centradas en la educación al paciente. Conclusiones: la educación al paciente ha generado resultados muy favorecedores en la calidad de vida y el alivio de los síntomas, así como en la comprensión de la enfermedad y su manejo en la vida diaria. Muchos de estos estudios han hecho partícipe a la enfermera en este proceso educativo del paciente, destacando su importancia en la instauración de una eficaz relación profesional-paciente que condicionará un posterior buen afrontamiento de la enfermedad. Los profesionales de enfermería deben tomar consciencia de su importancia en este proceso, adquiriendo un rol activo en el cuidado del paciente con Síndrome de Intestino Irritable.Objective: to determine the role of the nurse in process of caring for people with Irritable Bowel Syndrome. Method: narrative review based on the results obtained from the bibliographic search in Health Sciences databases: PubMed, CINHAL and Web Of Science. Results: 20 articles were selected as the most suitable to achieve the objectives set in the work. Two categories of analysis were generated: barriers that make coping and self-care difficult in patients with Irritable Bowel Syndrome, and nursing interventions aimed to improve their quality of life. People with Irritable Bowel Syndrome noted as the main limitations: the nature of the care received and the lack of information about the disease offered by professionals. The studies agree that interventions should be focused on patient education. Conclusions: patient education has generated very positive results in quality of life and on the severity of symptoms, as well as in the better understanding of the disease and its management in daily life. Many of these studies have involved the nurse in this educational process of the patient, highlighting its importance in the establishment of an effective professional-patient relationship that will determine a desirable coping of the disease. Nursing professionals must become aware of their importance in this process, acquiring an active role in the care of patients with Irritable Bowel Syndrom

The use of data mining to identify indicators of health-related quality of life in patients with irritable bowel syndrome

Aim.? To examine the health-related quality of life in a cohort of individuals with irritable bowel syndrome and to explore the use of several data-mining methods to identify which socio-demographic and irritable bowel syndrome symptoms are most highly associated with impaired health-related quality of life.Background.? Health-related quality of life can be adversely affected by irritable bowel syndrome. Little is presently known about the predictive factors that may influence the quality of life in these patients.Design.? Cross-sectional survey design involving the general population of the UK.Methods.? Individuals with symptoms of irritable bowel syndrome were recruited to a longitudinal cohort survey via a UK-wide newspaper advert. Health-related quality of life was measured using a battery of validated questionnaires. Several data-mining models to determine which factors are associated with impaired health-related quality of life are considered in this study and include logistic regression, a classification tree and artificial neural networks.Results.? As well as irritable bowel syndrome symptom severity, results indicate that psychological morbidity and socio-demographic factors such as marital status and employment status also have a major influence on health-related quality of life in irritable bowel syndrome.Conclusion.? Health-related quality of life is impaired in community-based individuals in the UK with irritable bowel syndrome. Although not always as easily interpreted as logistic regression, data-mining techniques indicate subsets of factors that are highly associated with impaired quality of life. These models tend to include subsets of irritable bowel syndrome symptoms and psychosocial factors.Relevance to clinical practice.? Identification of the role of psychological and socio-demographic factors on health-related quality of life may provide more insight into the nature of irritable bowel syndrome. Greater understanding of these factors will facilitate more flexible and efficient nursing assessment and management of this patient grou

Autogestão da ansiedade nos sobreviventes de cancro: revisão sistemática da literatura

Introdução: No cancro, a incorporação de necessidades de autogestão da doença e do regime terapêutico é influenciada pelas condições pessoais e contextuais de cada individuo. A ansiedade é uma dessas condições que pode obstaculizar a capacitação do sobrevivente do cancro para o processo de autogestão do seu processo saúde-doença. Compreender e apoiar este processo é um verdadeiro desafio para os profissionais de enfermagem. Objectivos: Pretende-se identificar os fatores desencadeantes da ansiedade, identificar as estratégias utilizadas pelos sobreviventes de cancro na gestão da ansiedade e identificar intervenções dos enfermeiros na promoção da autogestão da ansiedade após o término dos tratamentos do cancro. Metodologia: Foi realizada uma Revisão Sistemática da Literatura segundo o modelo do Instituto Joanna Briggs®.Este modelo norteou todo o processo da consecução deste estudo: protocolo de investigação; formulação da questão de investigação; determinação dos critérios de inclusão e exclusão dos estudos; avaliação metodológica dos estudos e extração de dados. Para a identificação dos estudos recorreu-se às bases de dados da MEDLINE with full text® e CINAHL Plus with full text®. Inicialmente foram identificados 1483 artigos, dos quais 12 foram incluídos na revisão. A identificação dos estudos e extração dos dados foi conduzida, de forma independente, por dois investigadores. A qualidade metodológica dos estudos foi avaliada através dos instrumentos preconizados pelo Instituto Joanna Briggs®. Resultados: Foram identificados os preditores da ansiedade nos estudos incluidos. Verificou-se que as estratégias de exercício físico, as estratégias focadas na perceção da doença, as estratégias de coping “focadas nos aspetos positivos” (otimismo) e o espirito de luta, o apoio social e as estratégias que reduzem as interações negativas podem ter efeitos benéficos na redução dos níveis de ansiedade e promover uma adequada gestão da doença. No que diz respeito à intervenção profissional de enfermagem, verificou-se que um programa de intervenção psico-educacional de grupo, um programa de reabilitação de grupo e autogestão do cancro, uma intervenção de terapia de grupo e uma intervenção de coaching para promover a comunicação entre o prestador de cuidados e o sobrevivente tiveram efeitos positivos nos níveis de ansiedade. Conclusões: Os estudos analisados nesta revisão permitem concluir que os profissionais de enfermagem podem assumir um papel colaborativo na gestão da ansiedade nas pessoas sobreviventes de cancro. No entanto, mais investigação é necessária para que os enfermeiros demostrem o seu contributo especifico para ganhos em saúde na fase de sobrevida após um cancro

An integrated clustering analysis framework for heterogeneous data

Big data is a growing area of research with some important research challenges that motivate our work. We focus on one such challenge, the variety aspect. First, we introduce our problem by defining heterogeneous data as data about objects that are described by different data types, e.g., structured data, text, time-series, images, etc. Through our work we use five datasets for experimentation: a real dataset of prostate cancer data and four synthetic dataset that we have created and made them publicly available. Each dataset covers different combinations of data types that are used to describe objects. Our strategy for clustering is based on fusion approaches. We compare intermediate and late fusion schemes. We propose an intermediary fusion approach, Similarity Matrix Fusion (SMF), where the integration process takes place at the level of calculating similarities. SMF produces a single distance fusion matrix and two uncertainty expression matrices. We then propose a clustering algorithm, Hk-medoids, a modified version of the standard k-medoids algorithm that utilises uncertainty calculations to improve on the clustering performance. We evaluate our results by comparing them to clustering produced using individual elements and show that the fusion approach produces equal or significantly better results. Also, we show that there are advantages in utilising the uncertainty information as Hkmedoids does. In addition, from a theoretical point of view, our proposed Hk-medoids algorithm has less computation complexity than the popular PAM implementation of the k-medoids algorithm. Then, we employed late fusion that aggregates the results of clustering by individual elements by combining cluster labels using an object co-occurrence matrix technique. The final cluster is then derived by a hierarchical clustering algorithm. We show that intermediate fusion for clustering of heterogeneous data is a feasible and efficient approach using our proposed Hk-medoids algorithm

Hypnotherapy for people living with IBS; what influences perceptions and effectiveness

Hypnotherapy is a complementary and alternative medicine (CAM) which is demonstrably effective in treating irritable bowel syndrome (IBS), a chronic functional condition, characterized by gastric pain. Hypnotherapy for IBS appears to be relatively little used by people living with the condition. Further, it is not known what delivery factors contribute to effectiveness. A mixed methods investigation was undertaken, starting with a narrative review of the public’s opinions of hypnosis and hypnotherapy. This found a broad positivity towards hypnotherapy, conditional upon associations with conventional medicine or psychology. A qualitative study followed which found a tendency towards disengagement with conventional medical services, and subsequent adoption of self-care measures, but that there was a low level of awareness of hypnotherapy for IBS and little idea how it might help. However, participants were broadly open to it. A systematic review, meta-analysis, and subgroup analysis of trials of hypnotherapy for IBS identified three factors within the delivery characteristics of a hypnotherapy for IBS intervention which were associated with effective outcomes: group, weekly and high-volume delivery. A survey into people with IBS’s attitudes towards hypnotherapy for IBS, identified that a lack of awareness and practical factors, such as travel time and cost, were the main barriers, but concerns regarding ability to enter trance and vulnerability in trance states were also present. The thesis has substantially advanced the existing knowledge regarding the understanding of hypnotherapy for IBS by people with the condition and what factors are associated with the success of the intervention. The findings show poor awareness of hypnotherapy for IBS and provides guidance for intervention delivery

Usabilidade pedagógica: um fator determinante na adoção do e-Learning no ensino superior

O artigo que apresentamos neste simpósio doutoral surge no âmbito do Curso de Doutoramento em Educação, especialidade em Tecnologias de Informação e Comunicação na Educação, do Instituto de Educação da Universidade de Lisboa. O estudo tem como objetivo principal propor e testar um modelo que permita explicar a intenção comportamental dos docentes do Ensino Superior aquando da adoção e uso continuado das plataformas de e-Learning. Para o efeito procura-se compreender o contributo da usabilidade pedagógica como fator determinante no processo de adoção da tecnologia