1,720,965 research outputs found
Costi ed efficacia della cura della schizofrenia con antipsicotici tipici e atipici
No full textCost-effectiveness of treatment of schizophrenia with typical and atypical antipsychotics
Introduction: Schizophrenia is a ravaging and costly mental illness. Treatment of schizophrenia is long term and involves different kinds of care (drugs, outpatient, hospital, and residential care). Antipsychotic drugs contribute substantially to control patients positive and negative symptoms. In the late 90's, new “atypical” antipsychotics have been introduced, which are supposed to be more effective, but also are more expensive. However evidence on cost-effectiveness of atypical drugs is yet limited.
Objective: First, to compare effectiveness and costs of 12 month treatment of schizophrenia, using typical and atypical antipsychotics, associated with psychiatric services. Second, to compare the three most prescribed atypical drugs (olanzapine, clozapine, and risperidone) to the drug of choice, haloperidol.
Patients and methods: This study originates from a large scale survey carried out in Lombardy (Italy) in the year 2000, where 9,817 psychiatric patients were assessed using the HoNOS scale. Out of 1,537 schizophrenic patients with an initial (January) and final (December) assessment, 365 patients meeting eligibility criteria were elected for the study on cost-effectiveness (NHS perspective). The study is based on the observation of real clinical behaviours; therefore patients are not randomised to different treatments.
Results: The group treated with typical antipsychotics (n = 117) reported a light increase in severity index (10.0 vs 10.2; n.s.), whereas in the atypical group (n = 248) there was a significant decrease (11.5 vs 10.0; p = 0.03). Haloperidol (–0.16; n.s.) and risperidone (–0.57; n.s.) subgroups showed no significant reduction of clinical severity, while olanzapine (–2.5; p = 0.05) and clozapine (–1.6; p = 0.02) subgroups proved a significant lowering. Therefore, the average annual total treatment cost per point of reduction on the HoNOS scale was € 6,754 for the atypical drugs and impossible to evaluate for the typical drugs. The same was € 4,554 for olanzapine, € 7,546 for clozapine, € 10,897 for risperidone, and € 22,394 for haloperidol. Assuming that typical neuroleptics are the first choice treatment for schizophrenia, the incremental costs for one point reduction on the severity scale is € 3,136 for atypical drugs; or is € 3,342 for olanzapine vs haloperidol (comparator), € 5,895 for clozapine, and € 6,591 for risperidone.
Conclusions: Although the pure cost for the atypical drugs is 16 times higher than for the typical ones (€ 1,563 vs € 96), the total treatment costs prove to be the most cost-effective and, among atypical drugs, olanzapine appears to be the best option
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
Psychotropic drug use in an Italian psychiatric hospital: a two-year-long follow-up study
No full textOBJECTIVE:
Following the introduction of guidelines of rational drug use, the pharmacoepidemiology of psychotropic drugs was investigated in a sample of long-stay patients living in a Italian psychiatric hospital.
DESIGN:
A prospective, longitudinal two-year follow-up study was carried out. Information about sociodemographic and clinical characteristics of the inpatient population, and about medications prescribed, was collected at baseline and after one and two years of follow-up.
SETTING:
Three wards of the psychiatric hospital of Milan.
MAIN OUTCOME MEASURES:
Number of patients taking psychotropic drugs, number of patients taking more than one neuroleptic or benzodiazepine, mean neuroleptic dose, psychopathological status according to the Brief Psychiatric Rating Scale (BPRS).
RESULTS:
70 patients were recruited and followed for two years. At follow-up a reduction in the number of patients taking neuroleptic drugs was recorded, together with a 50% decrease in the number of patients taking more than one neuroleptic. A reduction in the use of depot formulations was in addition shown. Patients taking benzodiazepines decreased of 50%. According to the BPRS, no psychopatological changes were observed during the study.
CONCLUSIONS:
These data suggest that education in psychopharmacology may guide towards a more rational use of drugs; longitudinal clinical audits should be implemented to monitor everyday practice
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
Parasympathetic impairment and reduced coronary reserve in some patients with cardiac syndrome X
No full textDispelling 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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