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1.
Adv Ther ; 41(8): 3089-3118, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38874879

RESUMEN

INTRODUCTION: Asthma management is strongly dependent on physician and patient beliefs and perceptions about the disease and its long-term treatment. The APPaRENT 3 study was conducted to explore factors influencing treatment choice and to understand patients' and physicians' attitudes and perspectives on the use of controller inhalers in regular versus flexible dosing for asthma management. METHODS: This cross-sectional survey of patients with asthma and treating physicians was conducted in seven countries: Indonesia, Malaysia, Philippines, Thailand, Vietnam (patient survey only), Saudi Arabia, and the United Arab Emirates. Assessment was carried out through an online/face-to-face questionnaire, where patients' viewpoints were focused on their attitudes and beliefs about asthma and treatment adherence, whereas physicians' viewpoints were gathered on their attitudes and beliefs about asthma management, knowledge of and adherence to asthma treatment guidelines, and asthma treatment regimens. RESULTS: Overall, 1400 patients (mean age, 34 years) and 599 physicians (mean age, 43 years) were included in the survey. Physicians similarly prioritised symptom control (39%) and exacerbation reduction (40%) in moderate asthma, whereas patients prioritised symptom control (41%) over exacerbation reduction (22%). Although both groups (physicians, 86%; patients, 84%) perceived asthma as well-controlled, poor management was evident based on Asthma Control Test (ACT) scores (mean, 15.7; standard deviation, 4.14; 82% had an ACT score < 20) and high symptom burden (39% reported nighttime awakenings or early mornings ≥ 2 nights/week). Most patients (76%) with moderate asthma were prescribed regular dosing, with the most common treatment being inhaled corticosteroid (ICS)/long-acting ß2-agonist (LABA) with as-needed inhaled short-acting ß2-agonist (SABA; 20%). Among patients on maintenance and reliever therapy, 93% of patients received a separate inhaled reliever. CONCLUSIONS: Despite high symptom burden, patients overestimated their level of asthma control. Physicians prioritised controlling symptoms and reducing exacerbations as treatment goals for moderate asthma, often prescribing regular dosing with ICS/LABA with as-needed inhaled SABA.


Managing asthma depends a lot on what doctors and patients think about the illness and its long-term treatment. This study looked into what influences treatment decisions and what patients and doctors think about using inhalers regularly or on an as-needed basis to manage asthma across seven countries (Indonesia, Malaysia, Philippines, Thailand, Vietnam [patient survey only], Saudi Arabia, and the United Arab Emirates). In this study, patients with asthma and doctors managing asthma completed an online/face-to-face questionnaire. The study aimed to understand what patients think about asthma and their treatment plan. Meanwhile, the doctors were asked what they think about managing asthma and how much they apply clinical guidelines for treating patients with asthma. Doctors believed it is equally important to control symptoms and prevent worsening of symptoms in patients with moderate asthma, while patients cared more about controlling symptoms than preventing worsening of symptoms. While doctors and patients both regarded asthma as well-controlled, many patients had low Asthma Control Test scores and experienced a lot of symptoms, suggesting that they are poor perceivers of asthma control. Most patients with moderate asthma were given regular treatment, usually with inhaled corticosteroid combined with long-acting ß2-agonist along with as-needed short-acting ß2-agonist as a reliever. Most patients who were prescribed the same inhaler for regular use and as a reliever also had a separate inhaler for quick relief of symptoms. This study shows the need for patients and doctors to have better conversations about asthma, its treatments, and what to expect from them.


Asunto(s)
Antiasmáticos , Asma , Humanos , Asma/tratamiento farmacológico , Asma/terapia , Masculino , Adulto , Femenino , Estudios Transversales , Antiasmáticos/uso terapéutico , Antiasmáticos/administración & dosificación , Persona de Mediana Edad , Malasia , Emiratos Árabes Unidos , Vietnam , Arabia Saudita , Indonesia , Actitud del Personal de Salud , Tailandia , Filipinas , Conocimientos, Actitudes y Práctica en Salud , Encuestas y Cuestionarios , Administración por Inhalación , Nebulizadores y Vaporizadores , Cumplimiento de la Medicación/estadística & datos numéricos , Adulto Joven , Costo de Enfermedad , Médicos/psicología
2.
Health Care Sci ; 3(2): 124-130, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38939614

RESUMEN

Over the past several decades, significant scientific progress in xenotransplantation has brought the field to the threshold of clinical trials. In the past 3 years in the United States, experimental pig kidney and heart xenotransplantation have been performed on human subjects recently declared dead by neurological criteria (decedents). In addition, two pig heart transplants have been carried out in living patients under the United States Food and Drug Administration's expanded access guidelines. However, though there has been a flurry of activity there remain unanswered questions regarding how the public views xenotransplantation, what concerns may exist, and how to address these concerns in a meaningful way. This paper aims to underscore the importance of public engagement in xenotransplantation, emphasizing the ongoing need for studies to assess public opinions. The current evidence on public engagement studies is reviewed and gaps in our understanding are identified. We propose practical steps to advance this field. Additional studies to determine the extent of racial/ethnic differences in attitudes to xenotransplantation should be conducted. Empirical and descriptive analysis of certain religious viewpoints-especially minority faiths-would be valuable. As public engagement is an important aspect of public acceptance of novel research that is accompanied by risk, we suggest that xenotransplantation biotechnology companies might consider leading the way in funding this research.

3.
Micromachines (Basel) ; 15(3)2024 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-38542650

RESUMEN

Autostereoscopy is usually perceived at finite viewpoints that result from the separated pixel array of a display system. With directionally illuminated autostereoscopy, the separation of the illumination channel from the image channel provides extra flexibility in optimizing the performance of autostereoscopy. This work demonstrates that by taking advantage of illumination freedom, seamless viewpoints in the sweet viewing region, where the ghosting does not cause significant discomfort, are realized. This realization is based on illuminating the screen with a polyline array of light emitting diodes (LEDs), and continuous viewpoints are generated through independent variation in the radiance of each individual LED column. This new method is implemented in the directionally illuminated display for both single and multiple viewers, proving its effectiveness as a valuable technique for achieving a high-quality and high-resolution autostereoscopic display with seamless viewpoints.

4.
J Infect Dis ; 229(3): 619-620, 2024 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-38386686
5.
Psychol Rep ; : 332941241227522, 2024 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-38217505

RESUMEN

Guns and gun violence have become a widely discussed and hotly debated concern across the United States. With gun violence on the rise and mass shootings provoking powerful emotional outrage, the question often rests with what can or should be done to rectify these societal issues. This paper examines the attitudes of guns expressed through two qualitative interviews of gun owners in the United States. The paper observes many of the same outrage amongst these gun owners of Americans with seemingly little to show in the way of public policy progress for protecting citizens. Still, differences persist in what should be or can be done. The paper recommends more expansive study on this critical group of citizens involved in future United States gun safety and policy debate.

6.
Sensors (Basel) ; 23(21)2023 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-37960553

RESUMEN

Road intersection is a kind of important navigation landmark, while existing detection methods exhibit clear limitations in terms of their robustness and efficiency. A real-time algorithm for road intersection detection and location in large-scale sparse point clouds is proposed in this paper. Different from traditional approaches, our method establishes the augmented viewpoints beam model to perceive the road bifurcation structure. Explicitly, the spatial features from point clouds are jointly extracted in various viewpoints in front of the robot. In addition, the evaluation metrics are designed to self-assess the quality of detection results, enabling our method to optimize the detection process in real time. Considering the scarcity of datasets for intersection detection, we also collect and annotate a VLP-16 point cloud dataset specifically for intersections, called NCP-Intersection. Quantitative and qualitative experiments demonstrate that the proposed method performs favorably against the other parallel methods. Specifically, our method performs an average precision exceeding 90% and an average processing time of approximately 88 ms/frame.

7.
China CDC Wkly ; 5(35): 785-787, 2023 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-37745264
8.
Adv Health Sci Educ Theory Pract ; 28(5): 1711-1722, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37071262

RESUMEN

Q methodology is a unique, yet underutilized methodology designed specifically to scientifically study subjectivity. Q, as it is most often referred to, is an appropriate methodology whenever a researcher is interested in uncovering and describing the multiple divergent viewpoints on any topic. Such discovery of viewpoints provides insight into the subjectivities related to policies, values, priorities, judgements, opinions, and decisions. The disciplines where Q has been used for research are many, and include health sciences, education, and other social science / behavioral science fields. Because of its rather idiosyncratic place in research, however, many Q methodologists are self-taught or seek education through a few select universities that offer graduate level Q courses. The key to successfully approaching a Q study is to embrace its unique approach to studying subjectivity such that it is a powerful tool in health science education and other fields. It is common to find inconsistencies related to Q terminology, analyses, and decision making across studies. There is often an over reliance on concepts that come from purely quantitative methodologies such as R factor analysis rather than embracing the qualitative-quantitative hybridity of Q. This article is written as a primer with a focus on understanding Q at a deeper level rather than a step-by-step guide.


Asunto(s)
Educación en Salud , Proyectos de Investigación , Educación en Salud/métodos
9.
Sustain Sci ; 17(6): 2459-2472, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35968230

RESUMEN

Transdisciplinary research (TDR) collaborations are considered effective when they yield relevant results for science and practice. In this context, the different expectations, experiences, skills, and disciplines of the team members involved determine TDR collaboration. Using the example of 13 team members involved in the 3-year TDR project 'Römerland Carnuntum 2040' (Austria), we aim to identify and compare diverse expectations regarding TDR collaboration. In doing so, we question the often emphasised dichotomy between science and practice as the main challenge of TDR collaboration and aim towards making individual expectations regarding TDR collaboration visible and tangible. The contribution of the present paper is twofold: on the one hand, we provide statements for a formative assessment to externalise implicit expectations, assumptions, and epistemologies of TDR project team members regarding TDR collaboration and results. On the other hand, we present the Q-methodology as a viable approach to uncover diverging viewpoints as visible, tangible, and enunciable differences that need to be acknowledged in early stages of TDR projects when allocating resources and planning further project steps. Our investigations result in two viewpoints: one emphasises learning, collective reflection, and knowledge exchange as the main TDR expectation. The second focuses on 'changing practices', assuming that the project supports the introduction of new practices for (sustainable) regional development. These diverging expectations reveal subconscious tensions, which have to be addressed when allocating resources and defining project success within the TDR project.

10.
Front Psychol ; 13: 855450, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35814046

RESUMEN

How do our bodies influence who we are? Recent research in cognitive neuroscience has examined consciousness associated with the self and related multisensory processing of bodily signals, the so-called bodily self-consciousness. A parallel line of research has highlighted the concept of the autobiographical self and the associated autonoetic consciousness, which enables us to mentally travel in time. The subjective re-experiencing of past episodes is described as re-living them from within or outside one's body. In this brief perspective, I aim to explore the underlying characteristics of self-consciousness and its relation to bodily signals and episodic memory. I will outline some recent behavioral and neuroimaging evidence indicating that bodily cues play a fundamental role in autobiographical memory. Finally, I will discuss these emerging concepts regarding the current understanding of bodily-self, autobiographical-self, their links to self-consciousness, and suggest directions for future research.

11.
Health Expect ; 25(1): 333-344, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34845790

RESUMEN

CONTEXT: It remains unclear whether there would be societal support for a lifestyle criterion for the healthcare priority setting. This study examines the viewpoints of experts in healthcare and the public regarding support for a lifestyle-related decision criterion, relative to support for the currently applied criteria, in the healthcare priority setting in the Netherlands. METHODS: We conducted a Q methodology study in samples of experts in healthcare (n = 37) and the public (n = 44). Participants (total sample N = 81) ranked 34 statements that reflected currently applied decision criteria as well as a lifestyle criterion for setting priorities in healthcare. The ranking data were subjected to principal component analysis, followed by oblimin rotation, to identify clusters of participants with similar viewpoints. FINDINGS: We identified four viewpoints. Participants with Viewpoint 1 believe that treatments that have been proven to be effective should be reimbursed. Those with Viewpoint 2 believe that life is precious and every effort should be made to save a life, even when treatment still results in a very poor state of health. Those with Viewpoint 3 accept government intervention in unhealthy lifestyles and believe that individual responsibility should be taken into account in reimbursement decisions. Participants with Viewpoint 4 attribute importance to the cost-effectiveness of treatments; however, when priorities have to be set, treatment effects are considered most important. All viewpoints were supported by a mix of public and experts, but Viewpoint 1 was mostly supported by experts and the other viewpoints were mostly supported by members of the public. CONCLUSIONS: This study identified four distinct viewpoints on the healthcare priority setting in the Netherlands, each supported by a mix of experts and members of the public. There seems to be some, but limited, support for a lifestyle criterion-in particular, among members of the public. Experts seem to favour the decision criteria that are currently applied. The diversity in views deserves attention when policymakers want to adhere to societal preferences and increase policy acceptance.


Asunto(s)
Atención a la Salud , Instituciones de Salud , Análisis Costo-Beneficio , Prioridades en Salud , Humanos , Estilo de Vida , Países Bajos
12.
F1000Res ; 10: 198, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34164113

RESUMEN

Background: The Structured Operational Research and Training Initiative (SORT IT) teaches the practical skills of conducting and publishing operational research (OR) to influence health policy and/or practice. In addition to original research articles, viewpoint articles are also produced and published as secondary outputs of SORT IT courses. We assessed the characteristics, use and influence of viewpoint articles derived from all SORT IT courses. Methods: This was a cross-sectional study involving all published viewpoint articles derived from the SORT IT courses held from August 2009 - March 2020. Characteristics of these papers were sourced from the papers themselves and from SORT-IT members involved in writing the papers. Data on use were sourced from the metrics provided on the online publishing platforms and from Google Scholar. Influence on policy and practice was self-assessed by the authors of the papers and was performed only for papers deemed to be 'calls for action'. Results: A total of 41 viewpoint papers were published. Of these, 15 (37%) were 'calls for action'. In total, 31 (76%) were published in open-access journals and the remaining 10 in delayed access journals. In 12 (29%) of the papers, first authors were from low and middle-income countries (LMICs). Female authors (54%) were included in 22, but only four (10%) and two (5%) of first and last authors respectively, were female. Only seven (17%) papers had available data regarding online views and downloads. The median citation score for the papers was four (IQR 1-9). Of the 15 'call for action' papers, six influenced OR capacity building, two influenced policy and practice, and three influenced both OR capacity building within SORT IT and policy and practice. Conclusion: Viewpoint articles generated during SORT IT courses appear to complement original OR studies and are valued contributors to the dissemination of OR practices in LMICs.


Asunto(s)
Creación de Capacidad , Investigación Operativa , Benchmarking , Estudios Transversales , Femenino , Humanos , Publicaciones
13.
Risk Manag Healthc Policy ; 14: 2553-2569, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34188567

RESUMEN

BACKGROUND: The uncertainty surrounding the COVID-19 crisis and the different approaches taken to manage it have triggered scientific controversies among experts. This study seeks to examine how the fragile nature of Israeli democracy accommodated differences of opinion between experts during the COVID-19 crisis. OBJECTIVE: To map and analyze the discourse between experts surrounding issues that were the topic of scientific controversy. To examine the viewpoints of the public regarding the positions of the different experts. METHODS AND SAMPLE: A sequential mixed study design. The qualitative research was a discourse analysis of 435 items that entailed mapping the voices of different experts regarding controversial topics. In the quantitative study, a total of 924 participants answered a questionnaire examining topics that engendered differences of opinion between the experts. RESULTS: The results showed that there was no dialogue between opposition and coalition experts. Moreover, the coalition experts labeled the experts who criticized them as "coronavirus deniers" and "anti-vaxxers." The coalition changed its opinion on one issue only-the issue of lockdowns. When we asked the public how they see the scientific controversy between the coalition and the opposition experts, they expressed support for opposition policies on matters related to the implications of the lockdowns and to transparency, while supporting government policy mainly on topics related to vaccinations. The research findings also indicate that personal and socio-demographic variables can influence how the public responds to the debate between experts. The main differentiating variables were the personal attribute of conservatism, locus of control, age, and nationality. CONCLUSION: Controversy must be encouraged to prevent misconceptions. The internal discourse in the committees that advise the government must be transparent, and coalition experts must be consistently exposed to the views of opposition experts, who must be free to voice their views without fear.

14.
Vet Clin North Am Food Anim Pract ; 37(2): 267-278, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34049658

RESUMEN

Establishing causation, otherwise known as causal assessment, is a difficult task, made more difficult by the variety of causal assessment frameworks available to consider. In this article, Bradford Hill viewpoints are used to discuss the evidence base for Moraxella bovis and Moraxella bovoculi being component causes of infectious bovine keratoconjunctivitis. Each of the nine Bradford Hill viewpoints are introduced and explained: strength, consistency, specificity, temporality, biologic gradient, plausibility, coherence, experiment, and analogy. Examples of how the viewpoints have been applied for other causal relations are provided, and then the evidence base for M bovis and M bovoculi is discussed.


Asunto(s)
Enfermedades de los Bovinos/microbiología , Queratoconjuntivitis Infecciosa/microbiología , Moraxella bovis , Moraxella , Infecciones por Moraxellaceae/veterinaria , Animales , Bovinos , Enfermedades de los Bovinos/diagnóstico , Infecciones por Moraxellaceae/microbiología
15.
Adv Health Sci Educ Theory Pract ; 26(3): 975-999, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33570670

RESUMEN

Recently, due to scarce resources and the need to provide an evidence-base for healthcare professions' education (HPE), HPE research centres internationally have turned to identifying priorities for their research efforts. Engaging a range of stakeholders in research priority setting exercises has been posited as one way to address the issues around reducing researcher bias and increasing social accountability. However, assigning individuals to single a priori stakeholder groups is complex, with previous research overlooking cross-category membership and agreement between individuals across groups. Further, analyses have pitched stakeholder groups against one another in an attempt to understand who prioritises what, and often fails to grasp rationales underlying priorities. A deeper understanding of who prioritises what research areas and why is required to consider applicability of results across contexts and deepen social accountability and transferability. A web-based Q-methodological approach with n=91 participants (who) from ten pre-classified stakeholder groups was employed with post-sort interviews (why). Sixty-seven Q-set items (Chinese/English languages) were developed from previous research (what). Participants were mainly from Taiwan, although international researchers were included. Q-sorting was undertaken in groups or individually, followed by post-sort interviews. Eighty-six participants' Q-sorts were included in the final analysis. Intercorrelations among Q-sorts were factor-analysed (Centroid method) and rotated analytically (Varimax method). Interviews were thematically analysed. Six Viewpoints with eigenvalues exceeding 1 were identified (range = 3.55-10.34; 42% total variance; 35/67 topics), mapping high/low priorities for research foci: Workplace teaching and learning; Patient dignity and healthcare safety; Professionalism and healthcare professionals' development; Medical ethics and moral development; Healthcare professionals' retention and success; Preparing for clinical practice. Eighteen rationales for prioritisation were identified: impact, organisational culture and deficit of educators/practitioners were most highly cited. Each Viewpoint, held by multiple stakeholders, comprised a unique set of topic-groupings, target study participants, beneficiaries and rationales. The two most prolific Viewpoints represent how different stakeholder groups highlight key complementary perspectives of healthcare professions' education in the workplace (efficacy of teaching/learning practices, application of knowledge/values). By illuminating the detail around each Viewpoint, and presenting an holistic description of the who-what-why in research priority setting, others wishing to undertake such an exercise can more easily identify how stakeholder Viewpoints and their epistemic beliefs can help shape healthcare professions' research agendas more generally.


Asunto(s)
Atención a la Salud , Personal de Salud , Humanos , Investigación , Investigadores , Lugar de Trabajo
16.
Toxicol Appl Pharmacol ; 417: 115461, 2021 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-33617892

RESUMEN

Cosmetic talc has been suggested to cause mesothelioma. To assess a potential causal relationship between cosmetic talc and mesothelioma, a quantitative weight of evidence analysis was performed in accordance with Hill's nine original guidelines for causal inference using a published empirical model to weight each respective guideline. Various epidemiological, toxicological, and exposure studies related to cosmetic talc and risk of mesothelioma were included in an evaluation of each of Hill's guidelines. Probabilities that the guidelines were true were assigned based on expert judgment. We applied a sensitivity analysis to evaluate the variability of our probability estimates. The overall probability of causality for cosmetic talc and mesothelioma was approximately 1.29% (range: 0.73%-3.96%). This low probability of causality supports the conclusion that cosmetic talc is not related to the development of mesothelioma.


Asunto(s)
Mesotelioma/inducido químicamente , Neoplasias Pleurales/inducido químicamente , Talco/efectos adversos , Animales , Causalidad , Humanos , Mesotelioma/diagnóstico , Mesotelioma/epidemiología , Neoplasias Pleurales/diagnóstico , Neoplasias Pleurales/epidemiología , Probabilidad , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Pruebas de Toxicidad
17.
Int J Med Inform ; 147: 104372, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33421687

RESUMEN

BACKGROUND AND OBJECTIVES: Picture Archiving and Communication System (PACS) can be considered as one of the most important information systems used in healthcare facilities and its usability problems can lead to delays in the acceptance of information systems, increased medical errors and also user dissatisfaction. The primary purpose of this study was to evaluate the usability of PACS from the perspective of its main users. METHODS: This study used a combination of qualitative and quantitative methods and was carried out in 2019 where the research community consisted of PACS in five selected companies in Iran. The statistical sample included 200 individuals using the PACS in several hospitals across the country. Moreover, the sample was selected using the multistage random method. The data were then collected using the standard Computer System Usability Questionnaire (CSUQ) consisting of 5 sections and 19 items. Finally, the data were analyzed by SPSS software, version 18 using both descriptive and inferential methods. Content analysis was done for the qualitative data sets. RESULTS: It was indicated that ease of use, as a category, was not significantly different from the perspective of various PACS users. However, the ANOVA test revealed that there were significant differences in terms of information quality, user interface quality, overall user satisfaction and usability of PACS from the users' perspectives. Furthermore, content analysis of users' comments showed that speeding up the image processing and frequent system failures were amongst the most positive and negative aspects of the PACS, respectively. CONCLUSIONS: According to the perspective of the users of the investigated PACS in Iran, the usability of these PACS had a favorable status regarding ease of use while provided lower information quality. Generally, based on the users' viewpoints, the PACS from Company B were the most usable while the PACS provided by Company D were the least usable. It is suggested that the information quality and user interface of systems be improved by using appropriate analysis and needs assessment of the end users.


Asunto(s)
Sistemas de Información Radiológica , Sistemas de Computación , Humanos , Irán , Programas Informáticos , Encuestas y Cuestionarios
18.
BMC Med Ethics ; 22(1): 4, 2021 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-33407392

RESUMEN

BACKGROUND: Egg freezing has emerged as a technology of assisted reproductive medicine that allows women to plan for the anticipated loss of fertility and hence to preserve the option to conceive with their own eggs. The technology is surrounded by value-conflicts and is subject to ongoing discussions. This study aims at contributing to the empirical-ethical debate by exploring women's viewpoints on egg freezing in Austria, where egg freezing for social reasons is currently not allowed. METHODS: Q-methodology was used to identify prevailing viewpoints on egg freezing. 46 female participants ranked a set of 40 statements onto a 9-column forced choice ranking grid according to the level of agreement. Participants were asked to explain their ranking in a follow-up survey. By-person factor analysis was used to identify distinct viewpoints which were interpreted using both the quantitative and the qualitative data. RESULTS: Three distinct viewpoints were identified: (1) "women should decide for themselves", (2) "we should accept nature but change policy", and (3) "we need an informed societal debate". These viewpoints provide insights into how biomedical innovations such as egg freezing are perceived by women in Austria and illustrate the normative tensions regarding such innovations. CONCLUSIONS: Acknowledging the different prioritizations of values regarding assisted reproductive technologies is important to better understand the underlying normative tensions in a country where egg freezing for social reasons is currently not allowed. The study adds new empirical insights to the ongoing debate by outlining and discussing viewpoints of those directly affected: women. Following up on the lay persons perspective is particularly important in the context of future biomedical innovations that may challenge established norms and create new tensions. It therefore also adds to the societal debate and supports evidence-informed policy making in that regard.


Asunto(s)
Preservación de la Fertilidad , Austria , Criopreservación , Femenino , Humanos , Técnicas Reproductivas Asistidas , Encuestas y Cuestionarios
19.
Soc Sci Med ; 272: 113708, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33516087

RESUMEN

OBJECTIVES: To obtain public support for the active disinvestment (i.e. policy decision to stop reimbursement) of healthcare interventions, it is important to have insight in what the public thinks about disinvestment and which considerations they find relevant in this context. Currently, evidence on relevant considerations in the disinvestment context is limited. Therefore, this study aimed to explore the societal views in the Netherlands on the active disinvestment of healthcare interventions and obtain insight into the considerations that are relevant for those holding the different views. METHODS: A Q-methodology study was conducted among a purposively selected sample of citizens (n = 43). Data were collected in June and July 2019. Participants individually ranked a set of 43 statements broadly covering the issues that participants could consider relevant in the disinvestment context, from 'least agree' to 'most agree'. Qualitative feedback on the statement ranking was collected from each participant using a questionnaire. Principal component analysis followed by oblimin rotation was used to identify clusters of participants with similar statement rankings. These clusters/factors were interpreted as distinct viewpoints using the factor arrays and qualitative questionnaire responses of participants. RESULTS: Four viewpoints were identified. People holding viewpoint I believe that reimbursement of necessary healthcare should be maintained, irrespective of its costs. People holding viewpoint II agree with viewpoint I, although they believe that necessity should be objectively determined. People holding viewpoint III think that unnecessary, ineffective and inefficient healthcare should be disinvested. People holding viewpoint IV, consider it most important that disinvestment decision-making processes are transparent and consistent. CONCLUSION: Insight in the distinct viewpoints identified in this study contributes to a better understanding of why it has been considered difficult to obtain public support for disinvestment of healthcare interventions, and can help policymakers to change their approach to disinvestment to increase public support.


Asunto(s)
Atención a la Salud , Instituciones de Salud , Costos y Análisis de Costo , Humanos , Países Bajos
20.
Reprod Biomed Soc Online ; 12: 32-43, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33319082

RESUMEN

Preserving the option to conceive through egg freezing (oocyte cryopreservation) is surrounded by value conflicts and diverse viewpoints, particularly when non-medical or so-called 'social' reasons are involved. The debate is controversial and shaped by normative perceptions of the life course, including concepts regarding reproductive ageing, gender, motherhood and biomedicalization. To unravel the controversy and systematically identify the variety of viewpoints on egg freezing, a Q-methodology study was conducted in The Netherlands between December 2018 and October 2019. Thirty-four women of reproductive age participated in the study. They ranked 40 statements according to their level of agreement, and explained their ranking during follow-up interviews. Data were analysed using by-person factor analysis and interpreted using both quantitative and qualitative data. Four viewpoints, of which the fourth was bipolar, were identified: (1) cautious about egg freezing technology; (2) my body, my choice; (3) egg freezing is unnatural; and (4) have children and have them early. The distinct viewpoints illustrate different prioritizations of values and normative dimensions of biomedical innovations. By knowing more about the prevalent opinions on egg freezing and the surrounding controversy, policy makers and practitioners can make better informed decisions in terms of promoting and providing patient-centred infertility care. The findings furthermore stimulate continuing scholarly work on egg freezing and other innovations in reproductive medicine which may continue to disrupt normative standards.

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