Parents' views on care of their very premature babies in neonatal intensive care units: a qualitative study

Background The admission of a very premature infant to the neonatal intensive care unit (NICU) is often a difficult time for parents. This paper explores parents’ views and experiences of the care for their very premature baby on NICU. Methods Parents were eligible if they had a baby born before 32 weeks gestation and cared for in a NICU, and spoke English well. 32 mothers and 7 fathers were interviewed to explore their experiences of preterm birth. Although parents’ evaluation of care in the NICU was not the aim of these interviews, all parents spoke spontaneously and at length on this topic. Results were analysed using thematic analysis. Results Overall, parents were satisfied with the care on the neonatal unit. Three major themes determining satisfaction with neonatal care emerged: 1) parents’ involvement; including looking after their own baby, the challenges of expressing breast milk, and easy access to their baby; 2) staff competence and efficiency; including communication, experience and confidence, information and explanation; and 3) interpersonal relationships with staff; including sensitive and emotional support, reassurance and encouragement, feeling like an individual. Conclusions Determinants of positive experiences of care were generally consistent with previous research. Specifically, provision of information, support for parents and increasing their involvement in the care of their baby were highlighted by parents as important in their experience of care

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Background: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.Carolina Foundation (Spain), Mario Benedetti Foundation of the University of Alicante, Regional Ministry of Education (Generalitat Valenciana) (BEST/2009/003). Healthcare Research Fund of the Spanish Ministry of Health and Social Policy (PI 0790470)

An efficient algorithm for structured sparse quantile regression

An efficient algorithm is derived for solving the quantile regression problem combined with a group sparsity promoting penalty. The group sparsity of the regression parameters is achieved by using a $ell_{1,infty}$-norm penalty (or constraint) on the regression parameters. The algorithm is efficient in the sense that it obtains the regression parameters for a wide range of penalty parameters, thus enabling easy application of a model selection criteria afterwards. A Matlab implementation of the proposed algorithm is provided and some applications of the methods are studied.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Diferenciais de gênero no impacto do arranjo familiar no status de saúde dos idosos brasileiros Gender differences in the impact of family arrangements on health status of Brazilian elderly

Analisam-se os diferenciais por gênero na relação do arranjo familiar com o status de saúde de pessoas com 65 anos ou mais, incorporando também fatores socioeconômicos e sociodemográficos. Utilizam-se dados da PNAD de 1998. Foram desenvolvidos diversos modelos de regressão logística para duas variáveis dependentes: auto-avaliação da saúde e declaração de doenças. Os fatores explicativos (área rural/urbana, idade, renda per capita, analfabetismo, arranjo familiar e condição no domicílio) foram incorporados seqüencialmente para avaliar as mudanças da inter-relação. Encontrou-se que, embora as mulheres tenham mais desvantagem quanto à declaração de doenças, a auto-avaliação da condição de sua saúde é relativamente similar à dos homens. Os diferenciais de gênero no padrão de arranjo familiar dos idosos são em parte responsáveis pela desvantagem no status de saúde das mulheres. Conclui-se que a formulação de políticas para o melhoramento do status de saúde do idoso deve considerar a existência de importantes diferenças de gênero no padrão da estrutura e arranjo de suas famílias. Existe necessidade de maior disponibilidade de inquéritos para idosos, que permitam aprofundamento na relação entre saúde do idoso, gênero e família.<br>In this work one explores gender differences in family arrangement and its relation to the health status of men and women over 65, taking into account socio-demographic and socioeconomic variables. Data were collected through a National Household Survey in 1998 that included a special supplement on health. Several logistic regression models were run for two dependent variables: health self assessment and report of chronic conditions. The explanatory variables (urban/rural area, age, per capita income, illiteracy, family arrangement, and household condition) were incorporated in a sequential way to assess changes in the relationship. It was found that, although women report more chronic conditions, there is a relative similarity in health self-assessment for both women and men. Gender differences in family arrangements patterns are partially responsible for the poorer health status of women. Health policies oriented to the older people must take into consideration the existent of important gender differences in family structure and family arrangements. There is a need of more detailed information on Brazilian household surveys as to disentangle the relationships between the older people&acute;s health, gender and family