1,721,002 research outputs found
Knowledge, attitudes and use of evidence-based practice among midwives in Belgium: A cross-sectional survey
No full textINTRODUCTION: Evidence-based practice (EBP) leads to improved health outcomes and reduces variability in the quality of care. However, literature on the knowledge, attitudes and use of EBP among midwives is scarce internationally and in Belgium. METHODS: A cross-sectional study using an online semi-structured questionnaire explored practice, attitudes and barriers on EBP and clinical practice guidelines. Midwives (n=251) working in university and non-university hospitals, primary care, and midwifery education, in Flanders (Belgium) were included. RESULTS: Midwives with a Master’s degree (57.7% vs 37.8%; p=0.004), ≤15 years since graduation (50.8% vs 35.5%; p=0.015) and aged <40 years (49.7% vs 34.6%; p=0.02), had better knowledge of the EBP-definition. The majority searched for literature (80.1%), mainly evidence-based (EB) clinical practice guidelines (50.6%), randomized controlled trials (45.0%) and systematic reviews (43.0%). Midwives found EBP necessary and realistic to apply in daily practice and support decision-making. They were willing to improve EBP-knowledge and skills but assumed to be competent in providing evidence-based care. Most respondents were convinced of the importance of EB clinical practice guidelines but did not believe guidelines facilitated their practices or enabled them to consider patient preferences adequately. Half of the midwives (55.8%) experienced barriers to EB clinical practice guideline use, mainly lack of time (35.9%), access (19.5%), and support (17.9%). CONCLUSIONS: Although midwives showed a positive attitude towards EBP, education programs to promote EBP and improve EBP-related knowledge and skills are needed. Future efforts should focus on developing strategies for overcoming barriers and enhancing the consistency of EBP implementation
Smoking during pregnancy: knowledge, attitudes and practice of gynecologists and midwives in Flanders, Belgium
No full textstatus: Publishe
Odisee ontwikkelt een App voor zorg bij vroeggeboorte
No full texthttps://www.lochristinaar.com/nieuws/odisee-ontwikkelt-een-app-voor-zorg-bij-vroeggeboortestatus: Publishe
Inflammatory response in maternal serum during preterm labour
Full text linkPreterm birth (PTB), defined as a delivery at less than 37 weeks of gestation, is the leading cause of perinatal morbidity and mortality worldwide. The serious effects of PTB on parents, infant and society make PTB an important issue to public health. Despite significant advances in perinatal care and advancing knowledge of risk factors and mechanisms associated with PTB, there has been little progress in reducing the PTB rate. Diagnosis of preterm labour as well as accurate prediction of PTB is notoriously difficult, because of the heterogeneity of the condition. PTB is a syndrome initiated by multiple mechanisms including infection or inflammation which is the only pathological process for which both a firm causal link with PTB has been established and a molecular pathophysiology defined. Intrauterine infection evokes an immune response that involves the release of cytokines and chemokines, prostaglandins and matrix-degrading enzymes. These substances trigger uterine contractions, membrane rupture and cervical ripening. Most intra-uterine infections are chronic and subclinical in nature and consequently hard to diagnose before labour or rupture of the membranes. A tremendous amount of efforts has been expended to identify markers to predict PTB and to improve our understanding of the mechanisms and pathways leading to PTB. The best studied site of infection is amniotic fluid, but obtaining this sample requires an invasive and sometimes risky procedure (e.g. amniocentesis). A non-invasive approach seems to be more relevant to clinical practice because of the feasibility and accessibility. However, few studies have investigated the maternal inflammatory response during preterm labour. Therefore, the overall objective of this study was to determine several inflammatory markers in maternal serum from pregnant women in labour (either term or preterm) vs. non-labouring controls.
We completed a nested case control study in which singleton pregnancies were recruited at the obstetric department of Ghent University Hospital and divided into groups according to gestational age and labour status. Multiple proteins were evaluated in maternal serum using enzyme-linked or multiplex bead immunoassays including soluble triggering receptor expressed on myeloid cells-1 (sTRE M-1), matrix metalloproteinases (MMP)-9 and MMP-3, tissue inhibitor of metalloproteinases (TIMP)-1, TIMP-2, TIMP-3 and TIMP-4 and a panel of 30 cytokines, chemokines and growth factors.
Our study showed that serum levels of sTRE M-1 were elevated during spontaneous term and preterm labour vs. non-labouring women. sTRE M-1 concentrations were significantly higher in preterm vs. term labour. In line with previous studies, MMP-9 concentrations were elevated during preterm labour. TIMP-1 and TIMP-2 were lower in preterm gestation, irrespective of labour, while TIMP-4 concentrations were raised in labour. One of the most intriguing findings of our study is that MMP-9:TIMP-1 and MMP-9:TIMP-2 balances in maternal serum were tilting in favour of matrix degradation (gelatinolysis) in women with preterm labour. This observation suggests that aberrant serum expression of MMP:TIMP ratios may provide a far less invasive method to determine enzymes essential in the degradation of extracellular matrix (EC M) during pregnancy and parturition. Among the 30 inflammatory serum markers, only hepatocyte growth factor (HGF) was increased in women with PTB, while interleukin (IL)-12 serum levels were lower in labouring women and interferon gamma induced protein (IP)-10 serum levels were higher in women at term gestation. This may indicate that the inflammatory response in serum of women with term and preterm labour is rather weak. Until present, few biomarkers have shown clinical usefulness, because they are nonspecific or become positive too late. Among the biomarkers evaluated to date, the most powerful and consistent predictors of PTB are the presence of foetal fibronectin in cervicovaginal fluid and a short cervix on transvaginal ultrasound examination. The clinical value of both tests primarily lies in their negative predictive value thereby guiding clinicians in decision-making and avoiding unnecessary interventions. During the last decades, it has become clear that single or universal biomarkers will not be capable to predict PTB accurately in all populations. Future research should focus on multiple biomarkers in different PTB subtypes to allow differentiation depending on the underlying causes. The future development of an accurate, minimally invasive multiple marker test is necessary to permit incorporation into clinical practice. The availability of new technologies capable of probing the genome offers exciting possibilities to gain new insights into the mechanisms leading to PTB and to develop targeted therapies
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Smoking and smoking cessation among Flemish women during pregnancy and postpartum
Full text linkTobacco use is an alarming public health problem worldwide and causes significant morbidity and mortality. Globally, 22% of the world’s population over 15 years are smokers. Smoking affects both male and female fertility in their reproductive age. Smoking during pregnancy is one of the single most important avoidable cause of adverse pregnancy outcomes.
This work provides an overview of the determinants of smoking and smoking cessation during pregnancy and postpartum, based on the levels of the socio-ecological model. A qualitative study explored knowledge, beliefs and practice among midwives and gynaecologists concerning smoking cessation among pregnant women. The second study tested the factorial structure, validity and reliability of the Dutch version of the Modified Reasons for Smoking Scale in a sample of smoking pregnant women. The third study obtained insight into the associations between smoking patterns and depressive feelings during pregnancy and postpartum, taking into account several sociodemographic characteristics. The final study analysed the association between smoking cessation beliefs and smoking status, and between smoking cessations beliefs and intention to quit smoking, using the Theory of Planned Behaviour in pregnant smokers and ex-smokers.
After presenting and discussing the results, recommendations and directions for further research are formulated, based on the socio-ecological model
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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