Development of a Predictive Model for Induction Success of Labour

Induction of the labour process is an extraordinarily common procedure used in some pregnancies. Obstetricians face the need to end a pregnancy, for medical reasons usually (maternal or fetal requirements) or less frequently, social (elective inductions for convenience). The success of induction procedure is conditioned by a multitude of maternal and fetal variables that appear before or during pregnancy or birth process, with a low predictive value. The failure of the induction process involves performing a caesarean section. This project arises from the clinical need to resolve a situation of uncertainty that occurs frequently in our clinical practice. Since the weight of clinical variables is not adequately weighted, we consider very interesting to know a priori the possibility of success of induction to dismiss those inductions with high probability of failure, avoiding unnecessary procedures or postponing end if possible. We developed a predictive model of induced labour success as a support tool in clinical decision making. Improve the predictability of a successful induction is one of the current challenges of Obstetrics because of its negative impact. The identification of those patients with high chances of failure, will allow us to offer them better care improving their health outcomes (adverse perinatal outcomes for mother and newborn), costs (medication, hospitalization, qualified staff) and patient perceived quality. Therefore a Clinical Decision Support System was developed to give support to the Obstetricians. In this article, we had proposed a robust method to explore and model a source of clinical information with the purpose of obtaining all possible knowledge. Generally, in classification models are difficult to know the contribution that each attribute provides to the model. We had worked in this direction to offer transparency to models that may be considered as black boxes. The positive results obtained from both the information recovery system and the predictions and explanations of the classification show the effectiveness and strength of this tool

Global transpiration data from sap flow measurements : the SAPFLUXNET database

Plant transpiration links physiological responses of vegetation to water supply and demand with hydrological, energy, and carbon budgets at the land-atmosphere interface. However, despite being the main land evaporative flux at the global scale, transpiration and its response to environmental drivers are currently not well constrained by observations. Here we introduce the first global compilation of whole-plant transpiration data from sap flow measurements (SAPFLUXNET, https://sapfluxnet.creaf.cat/, last access: 8 June 2021). We harmonized and quality-controlled individual datasets supplied by contributors worldwide in a semi-automatic data workflow implemented in the R programming language. Datasets include sub-daily time series of sap flow and hydrometeorological drivers for one or more growing seasons, as well as metadata on the stand characteristics, plant attributes, and technical details of the measurements. SAPFLUXNET contains 202 globally distributed datasets with sap flow time series for 2714 plants, mostly trees, of 174 species. SAPFLUXNET has a broad bioclimatic coverage, with woodland/shrubland and temperate forest biomes especially well represented (80 % of the datasets). The measurements cover a wide variety of stand structural characteristics and plant sizes. The datasets encompass the period between 1995 and 2018, with 50 % of the datasets being at least 3 years long. Accompanying radiation and vapour pressure deficit data are available for most of the datasets, while on-site soil water content is available for 56 % of the datasets. Many datasets contain data for species that make up 90 % or more of the total stand basal area, allowing the estimation of stand transpiration in diverse ecological settings. SAPFLUXNET adds to existing plant trait datasets, ecosystem flux networks, and remote sensing products to help increase our understanding of plant water use, plant responses to drought, and ecohydrological processes. SAPFLUXNET version 0.1.5 is freely available from the Zenodo repository (https://doi.org/10.5281/zenodo.3971689; Poyatos et al., 2020a). The "sapfluxnetr" R package - designed to access, visualize, and process SAPFLUXNET data - is available from CRAN.Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Violencia colectiva y salud pública

La Organización Mundial de la Salud define la violencia como el uso deliberado de la fuerza física o de poder, desarrolla una tipología de diversos tipos de violencia como: Violencia dirigida a uno mismo, violencia interpersonal y violencia colectiva. La causa de conductas violentas son multifacéticas y es necesario utilizar teorías multinivel, como el Modelo Socioeconómico, que categoriza la violencia e varios niveles: sociedad, comunidad, relaciones e individual

Familiarismo: ventajas y desventajas de "Mi familia"

A partir de 1970 los psicólogos, además de Interesarse en diferencias de carácter individual, se interesaron por las diferencias transculturales, los resultados de estas investigaciones indican que a través de las culturas existen diferencias en la proporción de individuos que exhiben ciertos patrones de conducta y pensamiento

The cross cultural variation of probability judgment accuracy: The influence of reasoning style

A very well established phenomenon in the judgment and decision making tradition is the overconfidence one places in the amount of knowledge that one possesses. A recent important finding is that knowledge calibration varies not only individually but across cultures as well. Although the cross-cultural variation of the overconfidence phenomenon has been established, further research is needed to investigate if it replicates in other cultures. Furthermore, research efforts attempting to explain cross-cultural variations in the overconfidence phenomenon have seldom been made. Most of the research conducted has focused on establishing that there is variation in this phenomenon across cultures. Thus, the mechanisms behind this effect remain elusive. Two studies were conducted to investigate whether the overconfidence effect generalizes to Mexican-American and Mexican participants and whether culture-related variables such as preference for quick decision making, holistic reasoning, and uncertainty orientation predict calibration indices. Results of two studies conducted on White American (N = 179), Mexican-American (N = 264), and Mexican participants (N = 164) corroborate the cross-cultural variation of probability judgment accuracy. Holistic reasoning fully mediated the association between intuitive decision-making and overconfidence. As in previous studies, White American participants displayed less overconfidence when compared to Mexican-American and Mexican participants. Results of study 2 indicated that a rapid feeling of knowing is not predictive of memory performance on participants with a greater predisposition to reason holistically. More research needs to be conducted to: (1) investigate the specific mechanism by which holistic reasoning exerts its effect, and (2) explain discrepant findings observed between patterns of results for the two overconfidence indices computed

HIV Testing as a Standard of Care for Men Who Have Sex With Men

In 2006, the Centers for Disease Control and Prevention (CDC) revised its HIV testing recommendations in health care settings. Current guidelines recommend that all patients aged 13 to 64 years be screened for HIV as part of routine medical care. Additionally, the CDC recommends that persons at high risk for HIV infection should be screened for HIV at least annually. Primary care providers in clinical settings are seen as important providers of HIV prevention services and will be critical to expand HIV testing rates, particularly among populations such as men who have sex with men (MSM). This article reports on results from a multifaceted study that combined qualitative and quantitative methods and targeted both MSM and primary care providers. Through a quantitative survey with 709 MSM in Wisconsin, we explored the relationship between having a primary care provider, risk behavior, and HIV testing patterns. In the qualitative portion of the study, we conducted structured interviews with 7 clinic medical directors to explore the acceptability and feasibility of increased HIV testing in clinical setting strategy among primary care providers. Consistent with previous research, the results of this study indicate that primary care providers can play a significant role in encouraging and facilitating annual routine testing as a standard of care for high-risk MSM. This article offers policy and practice recommendations based on these findings

Development of a Predictive Model for Induction Success of Labour

Induction of the labour process is an extraordinarily common procedure used in some pregnancies. Obstetricians face the need to end a pregnancy, for medical reasons usually (maternal or fetal requirements) or less frequently, social (elective inductions for convenience). The success of induction procedure is conditioned by a multitude of maternal and fetal variables that appear before or during pregnancy or birth process, with a low predictive value. The failure of the induction process involves performing a caesarean section. This project arises from the clinical need to resolve a situation of uncertainty that occurs frequently in our clinical practice. Since the weight of clinical variables is not adequately weighted, we consider very interesting to know a priori the possibility of success of induction to dismiss those inductions with high probability of failure, avoiding unnecessary procedures or postponing end if possible. We developed a predictive model of induced labour success as a support tool in clinical decision making. Improve the predictability of a successful induction is one of the current challenges of Obstetrics because of its negative impact. The identification of those patients with high chances of failure, will allow us to offer them better care improving their health outcomes (adverse perinatal outcomes for mother and newborn), costs (medication, hospitalization, qualified staff) and patient perceived quality. Therefore a Clinical Decision Support System was developed to give support to the Obstetricians. In this article, we had proposed a robust method to explore and model a source of clinical information with the purpose of obtaining all possible knowledge. Generally, in classification models are difficult to know the contribution that each attribute provides to the model. We had worked in this direction to offer transparency to models that may be considered as black boxes. The positive results obtained from both the information recovery system and the predictions and explanations of the classification show the effectiveness and strength of this tool