1,721,001 research outputs found
Narrative medicine, intensive care and burn out
Full text linkIntroduction Narrative Medicine puts the individual at the centre of the therapeutic relationship. It is a powerful tool to improve the collaboration between the patient and those who care for them. In addition narrative medicine, which is based on specific communication skills, allows healthcare professionals to reflect on the meaning of their profession. Intensive care unit is a department with strong relational pressures. This pression influences the actions of the professionals involved. The source of stress affects the way it is managed. One of the fields of application of narrative medicine is the assessment of perceived stress by health professionals. The purpose of our study was to investigate the well-being of healthcare staff in intensive care through a narrative approach.
Materials and methods The study was based on the voluntary participation of healthcare staff in two multi-purpose intensive therapies. Each subect had to write a fairy tale on a semi-structured basis anonymously. The structure of fairy tale was created with a particular focus on themes that could highlight burn out phenomena. The stories were read by two separate contacts who then confronted each other by analyzing clusters. In the end, the results were presented to all those who participated.
Results We collected thirty-eight stories. All the stories followed the date track. They were full of details, colors and characters. At the beginning of the stories they talked about separation but gradually they arrive at a respectful coexistence. The words and the recurring feelings were analyzed generating a cloud. The common trace was the positive propensity for the future. When we presented our results emerged a good match between the descriptions reported and the emotions that had been described.All participants were available to carry out further projects of narrative medicine.
Conclusions Intensive care doctors and nurses work in difficult, often conflicting environments. Despite their continued exposure to emotional conflicts, they may have difficulty expressing their feelings. This is an additional risk to develope burnout.Narrative medicine becomes a new model for reflecting on their profession and learning to talk about their inner world. Narrative medicine becomes a therapeutic act and often correlates with other forms of expression that help to recompose the painful fragments of a disease on oneself and on the relationship with the outside world
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
Microvascular dysfunction and skeletal muscle oxygenation assessed by phase-modulation near-infrared spectroscopy in patients with septic shock
No full textPostoperative pain treatment SIAARTI Recommendations 2010. Short version.
Full text linkAbstract: The aim of these recommendations is the revision of data published in 2002 in the "SIAARTI Recommendations for acute postoperative pain treatment". In this version, the SIAARTI Study Group for acute and chronic pain decided to grade evidence based on the "modified Delphi" method with 5 levels or recommendation strength. Analgesia is a fundamental right of the patient. The appropriate management of postoperative pain (POP) is known to significantly reduce perioperative morbidity, including the incidence of postoperative complications, hospital stay and costs, especially in high-risk patients (ASA III-V), those undergoing major surgery and those hospitalized in a critical unit (Level A). herefore, the treatment of POP represents a high-priority institutional objective, as well as an integral part of the treatment plan for "perioperative disease", which includes analgesia, early mobilization, early enteral nutrition and active physiokinesitherapy (Level A). In order to improve an ACUTE PAIN SERVICE organization, we recommend: - a plan list pain management that includes adequate preoperative evaluation, pain measurement, organization or existing resources, identification and training or involved personnel in order to assure Multimodal analgesia, early, mobilization, early enteral nutrition and active physiokinesitherapy (Level A); - the implementation of an Acute Pain Service, a multidisciplinary structure which includes an anesthetist (team coordinator), surgeons, nurses, physiotherapists and eventually other specialists; - referring to high-quality indicators in establishing an APS and considering the following key points in its organization (Level C): service adoption;
identifying a referring anesthetist who is on call 24 hours a day;
patient care during the night and weekend;
sharing, drafting and updating written therapeutic protocols;
continuous medical education;
systematic pain assessment;
data collection regarding the efficacy and safety of the implemented protocols;
at least one audit per year.
- a preoperative evaluation, including all the necessary information for the management of postoperative analgesia (Level C);
- to adequately inform the patient about the risks and benefits of drugs and procedures used to obtain the maximum efficacy from the administered treatments (Level D). We describe pharmacological and loco-regional techniques with special attention to day surgery and difficult populations. Risk management pathways must be the reference for early identification and treatment of adverse events and chronic pain development. (Minerva Anestesiol 2010;76-657-67
Risks and benefits of animal-assisted interventions for critically ill patients admitted to intensive care units
No full textBackground: Pets offer significant health benefits, from decreased cardiovascular risks to anxiety and post-traumatic stress improvements. Animal-assisted interventions (AAI) are not frequently practiced in the intensive care unit (ICU) for fear of health risk for critical patients because there is a hypothetical risk of zoonoses. Objectives: This systematic review aimed to collect and summarize available evidence about AAI in the ICU. The Review questions were “Do AAI improve the clinical outcome of Critically Ill Patients admitted to ICUs?” and “Are the zoonotic infections the cause of negative prognosis?”. Methods: The following databases were searched on 5 January 2023: Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, and PubMed. All controlled studies (randomized controlled, quasi-experimental, and observational studies) were included. The systematic review protocol has been registered on the International Prospective Register of Systematic Review (CRD42022344539). Results: A total of 1302 papers were retrieved, 1262 after the duplicate remotion. Of these, only 34 were assessed for eligibility and only 6 were included in the qualitative synthesis. In all the studies included the dog was the animal used for the AAI with a total of 118 cases and 128 controls. Studies have high variability, and no one has used increased survival or zoonotic risk as outcomes. Conclusions: The evidence on the effectiveness of AAIs in ICU settings is scarce and no data are available on their safety. AAIs use in the ICU must be considered experimental and follow the related regulation until further data will be available. Given the potential positive impact on patient-centered outcomes, a research effort for high-quality studies seems to be justified
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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